Provider Demographics
NPI:1376147025
Name:LESLIE DILLARD PLLC
Entity Type:Organization
Organization Name:LESLIE DILLARD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:DILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-646-9992
Mailing Address - Street 1:121 BELLE FOREST CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2157
Mailing Address - Country:US
Mailing Address - Phone:615-646-9992
Mailing Address - Fax:615-523-1352
Practice Address - Street 1:121 BELLE FOREST CIR STE 2
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2157
Practice Address - Country:US
Practice Address - Phone:615-646-9992
Practice Address - Fax:615-523-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty