Individual
DR. PAUL MELVIN LEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
899 N WILMOT RD, SUITE E4, TUCSON, AZ 85711-1714
(520) 745-9723
Mailing address
899 N WILMOT RD, SUITE E4, TUCSON, AZ 85711-1714
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D008310
AZ
1223G0001X
General Practice Dentistry
Primary
0025634
TX
Other
Enumeration date
06/29/2010
Last updated
09/28/2011
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