Provider Demographics
NPI:1083391114
Name:LEBLANC, SAVANNAH ADELINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:ADELINE
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SAVANNAH
Other - Middle Name:ADELINE
Other - Last Name:PICKETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:37 FORESIDE RD
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1832
Mailing Address - Country:US
Mailing Address - Phone:207-798-6700
Mailing Address - Fax:
Practice Address - Street 1:37 FORESIDE RD
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1832
Practice Address - Country:US
Practice Address - Phone:207-798-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN5070122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist