Individual
GRANT LEISHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
139 MARKET ST, FORT KENT, ME 04743-1410
(207) 834-3907
Mailing address
139 MARKET ST, FORT KENT, ME 04743-1410
(207) 834-3907
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN4701
ME
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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