Provider Demographics
NPI:1437328911
Name:THORNTON-LEONARD, RENE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:A
Last Name:THORNTON-LEONARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RENE
Other - Middle Name:A
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3805 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2462
Mailing Address - Country:US
Mailing Address - Phone:770-554-0848
Mailing Address - Fax:770-554-4569
Practice Address - Street 1:3805 HARRISON RD
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2462
Practice Address - Country:US
Practice Address - Phone:770-554-0848
Practice Address - Fax:770-554-4569
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0126431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics