Organization
BRIAN K. LEACH DDS LLC
Active
Other names
Shell Knob Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN K. LEACH D.D.S. (OWNER/DENTIST)
(417) 858-6527
Entity
Organization
Contact information
Practice address
25376 STATE HIGHWAY 39, SUITE 201, SHELL KNOB, MO 65747-7343
(417) 858-6527
Mailing address
PO BOX 226, SHELL KNOB, MO 65747-0226
(417) 858-6527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2009011494
MO
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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