Provider Demographics
NPI:1386863900
Name:LEINS, LEO THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:THOMAS
Last Name:LEINS
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 1:9695 S. YOSEMITE
Mailing Address - Street 2:SUITE 327
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2888
Mailing Address - Country:US
Mailing Address - Phone:303-671-0761
Mailing Address - Fax:720-881-7446
Practice Address - Street 1:9695 S. YOSEMITE
Practice Address - Street 2:SUITE 327
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2888
Practice Address - Country:US
Practice Address - Phone:303-671-0761
Practice Address - Fax:720-881-7446
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COH-D-1-05392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist