Provider Demographics
NPI:1578897930
Name:SEGLER, LESLIE NAN
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:NAN
Last Name:SEGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 TANNER WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-8322
Mailing Address - Country:US
Mailing Address - Phone:251-391-8429
Mailing Address - Fax:
Practice Address - Street 1:8501 TANNER WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-8322
Practice Address - Country:US
Practice Address - Phone:251-441-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant