Provider Demographics
NPI:1881206597
Name:RONALD P. LEYDER, DDS
Entity Type:Organization
Organization Name:RONALD P. LEYDER, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:LEYDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-652-1663
Mailing Address - Street 1:7166 S CROTON HARDY DR
Mailing Address - Street 2:
Mailing Address - City:NEWAYGO
Mailing Address - State:MI
Mailing Address - Zip Code:49337-7707
Mailing Address - Country:US
Mailing Address - Phone:231-652-1663
Mailing Address - Fax:
Practice Address - Street 1:7166 S CROTON HARDY DR
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337-7707
Practice Address - Country:US
Practice Address - Phone:231-652-1663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental