Provider Demographics
NPI:1891055968
Name:LEONARD F. ANGLIS
Entity Type:Organization
Organization Name:LEONARD F. ANGLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:ANGLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-226-9380
Mailing Address - Street 1:1549 S COURT ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-4809
Mailing Address - Country:US
Mailing Address - Phone:219-226-9380
Mailing Address - Fax:219-226-9381
Practice Address - Street 1:1549 S COURT ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-4809
Practice Address - Country:US
Practice Address - Phone:219-226-9380
Practice Address - Fax:219-226-9381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007805B261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental