Individual
NATHAN DONN LEISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1525 OLYMPIC HWY N, SHELTON, WA 98584-3049
(360) 426-9711
Mailing address
1504 SIOUX DR, MARION, IL 62959-5209
(618) 997-0127
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60227116
WA
Other
Enumeration date
08/03/2011
Last updated
03/27/2018
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