Individual
DR. DANNY BLAINE LEEDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
414 UNION STREET - 8TH FLOOR, SMILE DIRECT CLUB - INSURANCE DEPARTMENT, NASHVILLE, TN 37219
(800) 688-4010
Mailing address
302 S FULTON ST, CLARKSVILLE, AR 72830-3616
(479) 754-0459
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3197
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136700608
—
AR
01
—
485722
UCCI
AR
01
—
5T397
BC/BS
AR
Enumeration date
08/05/2006
Last updated
02/15/2018
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