Individual
DR. JEREMY D LELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
3622 WILLIAMS DR, BLDG 1, GEORGETOWN, TX 78628-2415
(512) 869-0529
(512) 498-0154
Mailing address
PO BOX 49500, AUSTIN, TX 78765-9500
(512) 454-1220
(512) 467-0363
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
23361
TX
390200000X
Student in an Organized Health Care Education/Training Program
23361
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/12/2007
Last updated
09/19/2013
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