Individual
JEFFREY RANDALL LEIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1301 FIRST COLONIAL ROAD, VIRGINIA BEACH, VA 23454
(757) 463-1500
(757) 463-8727
Mailing address
1301 FIRST COLONIAL ROAD, VIRGINIA BEACH, VA 23454
(757) 463-1500
(757) 463-8727
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006498
VA
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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