Provider Demographics
NPI:1568550895
Name:STEVEN A. LEACH,DMD,PC
Entity Type:Organization
Organization Name:STEVEN A. LEACH,DMD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-353-3211
Mailing Address - Street 1:2002 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6021
Mailing Address - Country:US
Mailing Address - Phone:256-353-3211
Mailing Address - Fax:256-353-4345
Practice Address - Street 1:2002 FLINT RD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6021
Practice Address - Country:US
Practice Address - Phone:256-353-3211
Practice Address - Fax:256-353-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty