Provider Demographics
NPI:1619030301
Name:LEONHART, VICTORIA LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LYNN
Last Name:LEONHART
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 1:11345 ALAMO RANCH PKWY
Mailing Address - Street 2:STE 104
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006
Mailing Address - Country:US
Mailing Address - Phone:210-289-1431
Mailing Address - Fax:
Practice Address - Street 1:11345 ALAMO RANCH PKWY
Practice Address - Street 2:STE 104
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:210-289-1431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28846122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist