Individual
DR. CORRIE CHRISTOPHER LEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3914 PRINCETON DR, SANTA ROSA, CA 95405-7014
(707) 546-2129
(707) 546-2131
Mailing address
3914 PRINCETON DR, SANTA ROSA, CA 95405-7014
(707) 546-2129
(707) 546-2131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30919
CA
Other
Enumeration date
11/25/2007
Last updated
11/25/2007
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