Provider Demographics
NPI:1396367462
Name:LEONG, CAMILLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:
Last Name:LEONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 ZINFANDEL DR STE 400
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6391
Mailing Address - Country:US
Mailing Address - Phone:585-844-6165
Mailing Address - Fax:
Practice Address - Street 1:3100 ZINFANDEL DR STE 400
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6391
Practice Address - Country:US
Practice Address - Phone:844-616-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1058831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics