Provider Demographics
NPI:1336130913
Name:HUTCHINS, LESLIE H (DDS)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:H
Last Name:HUTCHINS
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 1:3711 EUBANK BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3577
Mailing Address - Country:US
Mailing Address - Phone:505-293-2233
Mailing Address - Fax:505-293-2234
Practice Address - Street 1:3711 EUBANK BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3577
Practice Address - Country:US
Practice Address - Phone:505-293-2233
Practice Address - Fax:505-293-2234
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM9751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice