Provider Demographics
NPI:1790740587
Name:PHILIP A LEONE DDS INC
Entity Type:Organization
Organization Name:PHILIP A LEONE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-792-2749
Mailing Address - Street 1:5669 MAHONING AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515
Mailing Address - Country:US
Mailing Address - Phone:330-792-2749
Mailing Address - Fax:330-792-1128
Practice Address - Street 1:5669 MAHONING AVE
Practice Address - Street 2:SUITE A
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515
Practice Address - Country:US
Practice Address - Phone:330-792-2749
Practice Address - Fax:330-792-1128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30015982122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty