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Individual

DR. LESLIE BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4716 ILLINOIS RD, FORT WAYNE, IN 46804-5122
(260) 739-1906
Mailing address
430 N PARK AVE, UNIT 408, INDIANAPOLIS, IN 46202-3676
(405) 990-0125

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012537A
IN

Other

Enumeration date
06/15/2016
Last updated
06/15/2016
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