Provider Demographics
NPI:1326267287
Name:LEONARD, DAN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:D
Last Name:LEONARD
Suffix:
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 1:6609 BLANCO RD STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6152
Mailing Address - Country:US
Mailing Address - Phone:210-525-8711
Mailing Address - Fax:210-344-6560
Practice Address - Street 1:6609 BLANCO RD STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6152
Practice Address - Country:US
Practice Address - Phone:210-525-8711
Practice Address - Fax:210-344-6560
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice