Provider Demographics
NPI:1437810470
Name:LEANNE K TINSLEY DMD, P.L.L.C.
Entity Type:Organization
Organization Name:LEANNE K TINSLEY DMD, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-341-9531
Mailing Address - Street 1:10692 S US HIGHWAY 1 STE A
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-6408
Mailing Address - Country:US
Mailing Address - Phone:772-335-0660
Mailing Address - Fax:
Practice Address - Street 1:10692 S US HIGHWAY 1 STE A
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-6408
Practice Address - Country:US
Practice Address - Phone:772-335-0660
Practice Address - Fax:772-335-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty