Individual
MACAIRA LEAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1576 MAIN ST, WINDSOR, CO 80550-7909
(319) 335-7440
Mailing address
1576 MAIN ST, WINDSOR, CO 80550-7909
(319) 335-7440
(193) 335-7451
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DEN.00205523
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09548
STATE LICENSE
IA
01
—
DEN.00205523
STATE LICENSE
CO
Enumeration date
07/26/2018
Last updated
09/19/2023
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