Provider Demographics
NPI:1053643460
Name:LECLAIRE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:LECLAIRE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STECHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-541-4087
Mailing Address - Street 1:126 S CODY RD
Mailing Address - Street 2:PO BOX 814
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-9236
Mailing Address - Country:US
Mailing Address - Phone:563-289-3249
Mailing Address - Fax:
Practice Address - Street 1:126 S CODY RD
Practice Address - Street 2:
Practice Address - City:LE CLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753-9236
Practice Address - Country:US
Practice Address - Phone:563-289-3249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental