Provider Demographics
NPI:1346330388
Name:PATELLA, LEONARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:PATELLA
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 1:300 GARDEN CITY PLAZA
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3330
Mailing Address - Country:US
Mailing Address - Phone:516-739-8659
Mailing Address - Fax:516-742-0916
Practice Address - Street 1:300 GARDEN CITY PLAZA
Practice Address - Street 2:SUITE 212
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3330
Practice Address - Country:US
Practice Address - Phone:516-739-8659
Practice Address - Fax:516-742-0916
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist