Provider Demographics
NPI:1215042890
Name:GREENLEY, LEAH ELIZABETH JULIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:ELIZABETH JULIAN
Last Name:GREENLEY
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 1:7275 WEST 147TH STREET SUITE 102
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124
Mailing Address - Country:US
Mailing Address - Phone:952-432-1400
Mailing Address - Fax:952-997-3740
Practice Address - Street 1:7275 WEST 147TH STREET SUITE 102
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124
Practice Address - Country:US
Practice Address - Phone:952-432-1400
Practice Address - Fax:952-997-3740
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11675122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist