Individual
LEAHA NELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
101 N DOUGLAS BLVD STE T, MIDWEST CITY, OK 73130-3328
(405) 455-9057
Mailing address
101 N DOUGLAS BLVD STE T, MIDWEST CITY, OK 73130-3328
(405) 455-9057
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6794
OK
Other
Enumeration date
06/16/2016
Last updated
10/02/2020
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