Provider Demographics
NPI:1376829978
Name:CHAMBERS, LESLIE N (DDS)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:N
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:N
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7 OMRS/SGXD
Mailing Address - Street 2:697 LOUISIANA DR
Mailing Address - City:DYESS AFB
Mailing Address - State:TX
Mailing Address - Zip Code:79607
Mailing Address - Country:US
Mailing Address - Phone:325-696-8607
Mailing Address - Fax:
Practice Address - Street 1:7 OMRS/SGXD
Practice Address - Street 2:697 LOUISIANA DR
Practice Address - City:DYESS AFB
Practice Address - State:TX
Practice Address - Zip Code:79607
Practice Address - Country:US
Practice Address - Phone:325-696-8607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN-105091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice