Individual
DR. ELADIO DELEON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-1001
(706) 721-2421
(706) 721-6778
Mailing address
1430 JOHN WESLEY GILBERT DRIVE GC-1012, AUGUSTA, GA 30912-0001
(706) 721-7913
(706) 721-6778
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN123006
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN8796
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DNF000275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000801028A
—
GA
05
—
ZG0275
—
SC
Enumeration date
05/17/2006
Last updated
04/18/2023
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