Provider Demographics
NPI:1497702146
Name:LEONARD E. NOUD DMD, PA
Entity Type:Organization
Organization Name:LEONARD E. NOUD DMD, PA
Other - Org Name:BOCA HAMPTONS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:NOUD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-488-6311
Mailing Address - Street 1:9070 KIMBERLY BLVD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2855
Mailing Address - Country:US
Mailing Address - Phone:561-488-6311
Mailing Address - Fax:561-477-1517
Practice Address - Street 1:9070 KIMBERLY BLVD
Practice Address - Street 2:SUITE 26
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2855
Practice Address - Country:US
Practice Address - Phone:561-488-6311
Practice Address - Fax:561-477-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty