Individual
AZENETH DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3642
(953) 718-6494
Mailing address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3642
(953) 718-6494
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
15739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15739
TEXAS DENTAL LICENSE
TX
Enumeration date
11/19/2012
Last updated
11/19/2012
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