Provider Demographics
NPI:1093038408
Name:KOTZE, LEONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONE
Middle Name:
Last Name:KOTZE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 5594
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277
Mailing Address - Country:US
Mailing Address - Phone:941-921-0300
Mailing Address - Fax:
Practice Address - Street 1:7129 CURTISS AVE.
Practice Address - Street 2:SUITE 1
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:941-921-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist