Provider Demographics
NPI:1215366588
Name:LEBLEU, BRITTANY (RDH)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:LEBLEU
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:RANGELY
Mailing Address - State:CO
Mailing Address - Zip Code:81648-3114
Mailing Address - Country:US
Mailing Address - Phone:970-629-9302
Mailing Address - Fax:
Practice Address - Street 1:2640 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1900
Practice Address - Country:US
Practice Address - Phone:970-241-4937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO906370124Q00000X
UT7999679-0701124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist