Provider Demographics
NPI:1043602782
Name:LESH, AUBREY C (RDH)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:C
Last Name:LESH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:EARNHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5910 STETSON HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3580
Mailing Address - Country:US
Mailing Address - Phone:719-694-0400
Mailing Address - Fax:
Practice Address - Street 1:5910 STETSON HILLS BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3580
Practice Address - Country:US
Practice Address - Phone:719-694-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002023914124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO002023914Medicaid