Provider Demographics
NPI:1205220340
Name:LAING GIBBARD, LESLIE PATRICIA (MSC, PHD, DDS, MSC)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:PATRICIA
Last Name:LAING GIBBARD
Suffix:
Gender:F
Credentials:MSC, PHD, DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:107 SILVER BIRCH AVENUE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M4E 3L3
Mailing Address - Country:CA
Mailing Address - Phone:416-573-5307
Mailing Address - Fax:416-975-0917
Practice Address - Street 1:322 DENTAL SCIENCE S
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1001
Practice Address - Country:US
Practice Address - Phone:319-335-7440
Practice Address - Fax:319-335-7451
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ06503901223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics