Provider Demographics
NPI:1366673519
Name:COMFORT DENTAL ROCKWALL PLLC
Entity Type:Organization
Organization Name:COMFORT DENTAL ROCKWALL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEINWEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-771-4603
Mailing Address - Street 1:515 E I30
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-5408
Mailing Address - Country:US
Mailing Address - Phone:214-771-4603
Mailing Address - Fax:214-771-4610
Practice Address - Street 1:515 E I30
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5408
Practice Address - Country:US
Practice Address - Phone:214-771-4603
Practice Address - Fax:214-771-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty