Provider Demographics
NPI:1437283249
Name:SAULLE, LEONARDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:
Last Name:SAULLE
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 1:251 OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5108
Mailing Address - Country:US
Mailing Address - Phone:631-427-8655
Mailing Address - Fax:631-427-8566
Practice Address - Street 1:251 OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-5108
Practice Address - Country:US
Practice Address - Phone:631-427-8655
Practice Address - Fax:631-427-8566
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0411411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice