Individual
DR. LEAH MARIE VERNACCHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4299 ORCHARD LAKE RD # 196, WEST BLOOMFIELD, MI 48323-1681
(248) 344-8400
Mailing address
700 S BLAIR AVE, ROYAL OAK, MI 48067
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901022264
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901022264
DENTAL LICENSE
MI
Enumeration date
05/29/2020
Last updated
05/29/2020
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