Organization
JOHN W. LECLAIR DMD
Active
Other names
Dental Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W LECLAIR D.M.D. (OWNER)
(814) 441-4432
Entity
Organization
Contact information
Practice address
1315 W COLLEGE AVE, SUITE 201, STATE COLLEGE, PA 16801-2776
(814) 954-7620
(814) 308-9985
Mailing address
1315 W COLLEGE AVE, SUITE 201, STATE COLLEGE, PA 16801-2776
(814) 954-7620
(814) 308-9985
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS017092L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010324310005
—
PA
Enumeration date
01/26/2017
Last updated
01/26/2017
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