Provider Demographics
NPI:1649391491
Name:FROEBEL, LESLIE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:FROEBEL
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 1:1975 GUILFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4300
Mailing Address - Country:US
Mailing Address - Phone:614-488-1252
Mailing Address - Fax:614-488-1259
Practice Address - Street 1:1975 GUILFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4300
Practice Address - Country:US
Practice Address - Phone:614-488-1252
Practice Address - Fax:614-488-1259
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH199841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice