Provider Demographics
NPI:1003176819
Name:LEONARDI, DANIELLE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MARIE
Last Name:LEONARDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GARDNER STREET UNIT 7
Mailing Address - Street 2:UNIT 7
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134
Mailing Address - Country:US
Mailing Address - Phone:440-554-2353
Mailing Address - Fax:
Practice Address - Street 1:1423 BROADWAY
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906
Practice Address - Country:US
Practice Address - Phone:440-554-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-26
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18559521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice