Provider Demographics
NPI:1053673111
Name:RICHARD LEUNG DDS PLLC
Entity Type:Organization
Organization Name:RICHARD LEUNG DDS PLLC
Other - Org Name:TEMPLE DENTAL TRAILS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-892-9796
Mailing Address - Street 1:3550 S GENERAL BRUCE DR
Mailing Address - Street 2:SUITE D103
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-5138
Mailing Address - Country:US
Mailing Address - Phone:254-771-1115
Mailing Address - Fax:254-771-1151
Practice Address - Street 1:3550 S GENERAL BRUCE DR
Practice Address - Street 2:SUITE D103
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5138
Practice Address - Country:US
Practice Address - Phone:254-771-1115
Practice Address - Fax:254-771-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX263551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty