Provider Demographics
NPI:1013208263
Name:LEONARD, JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:LEONARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ROUTE 73
Mailing Address - Street 2:SUITE 1202 STURBRIDGE OFFICE PARK
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-9546
Mailing Address - Country:US
Mailing Address - Phone:856-753-2900
Mailing Address - Fax:856-753-5151
Practice Address - Street 1:180 ROUTE 73
Practice Address - Street 2:SUITE 1202 STURBRIDGE OFFICE PARK
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9546
Practice Address - Country:US
Practice Address - Phone:856-753-2900
Practice Address - Fax:856-753-5151
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI0104671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice