Individual
DR. LEONARD CARL MEDURA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1 TARLETON AVE, DALLAS, PA 18612-1248
(570) 675-1138
(570) 675-2152
Mailing address
21 WELLINGTON RD, SHAVERTOWN, PA 18708-1341
(570) 675-1138
(570) 675-2152
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS017342L
PA
Other
Enumeration date
07/15/2005
Last updated
05/11/2017
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