Individual
DR. SHANNON BRANDELL LEAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1500 TOWN SIDE DR., STE. 105, APEX, NC 27502
(919) 363-4204
Mailing address
1729 WHITE DOGWOOD RD, APEX, NC 27502-9098
(919) 362-4318
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7827
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903125
—
NC
Enumeration date
01/29/2007
Last updated
07/08/2007
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