Provider Demographics
NPI:1083881379
Name:LEON GENERAL DENTISTRY
Entity Type:Organization
Organization Name:LEON GENERAL DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:MOUNSDON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:641-446-7766
Mailing Address - Street 1:201 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:IA
Mailing Address - Zip Code:50144-1642
Mailing Address - Country:US
Mailing Address - Phone:641-446-7766
Mailing Address - Fax:
Practice Address - Street 1:201 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LEON
Practice Address - State:IA
Practice Address - Zip Code:50144-1642
Practice Address - Country:US
Practice Address - Phone:641-446-7766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06687261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental