Provider Demographics
NPI:1093754194
Name:DIAMOND, LEONARD ARTHUR I (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ARTHUR
Last Name:DIAMOND
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MIDLAND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2211
Mailing Address - Country:US
Mailing Address - Phone:201-991-6300
Mailing Address - Fax:201-991-6409
Practice Address - Street 1:50 MIDLAND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2211
Practice Address - Country:US
Practice Address - Phone:201-991-6300
Practice Address - Fax:201-991-6409
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI15059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist