Individual
DR. CHAD ROBERT LEIGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
830 N THEATRE RD, MARION, IN 46952-1700
(765) 664-0028
(765) 673-0488
Mailing address
830 N THEATRE RD, MARION, IN 46952-1700
(765) 664-0028
(765) 673-0488
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009572
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100124390
—
IN
Enumeration date
10/12/2006
Last updated
03/28/2018
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