Provider Demographics
NPI:1033258066
Name:SABO, LESLIE G
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:G
Last Name:SABO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19713 EXECUTIVE PARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874
Mailing Address - Country:US
Mailing Address - Phone:301-540-1034
Mailing Address - Fax:301-916-6442
Practice Address - Street 1:19713 EXECUTIVE PARK CIRCLE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874
Practice Address - Country:US
Practice Address - Phone:301-540-1034
Practice Address - Fax:301-916-6442
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6068122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist