Provider Demographics
NPI:1518564046
Name:LEISHMAN DENTAL
Entity Type:Organization
Organization Name:LEISHMAN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-432-6146
Mailing Address - Street 1:121 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:BATESBURG LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29006-1974
Mailing Address - Country:US
Mailing Address - Phone:803-532-6146
Mailing Address - Fax:
Practice Address - Street 1:121 N PINE ST
Practice Address - Street 2:
Practice Address - City:BATESBURG LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29006-1974
Practice Address - Country:US
Practice Address - Phone:803-532-6146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty