Provider Demographics
NPI:1558364521
Name:LEEMAN, RAMONA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:L
Last Name:LEEMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 BEACON ST
Mailing Address - Street 2:STE 409
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5622
Mailing Address - Country:US
Mailing Address - Phone:617-277-0033
Mailing Address - Fax:617-739-6800
Practice Address - Street 1:1051 BEACON ST
Practice Address - Street 2:STE 409
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5622
Practice Address - Country:US
Practice Address - Phone:617-277-0033
Practice Address - Fax:617-739-6800
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-20
Provider Licenses
StateLicense IDTaxonomies
MA149561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAXX11558OtherBC/BS