Provider Demographics
NPI:1932292059
Name:LEO T LEINS DDS PC
Entity Type:Organization
Organization Name:LEO T LEINS DDS PC
Other - Org Name:LONE TREE DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-671-0761
Mailing Address - Street 1:9695 SOUTH YOSEMITE
Mailing Address - Street 2:SUITE 327
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2888
Mailing Address - Country:US
Mailing Address - Phone:303-671-0761
Mailing Address - Fax:720-881-7446
Practice Address - Street 1:9695 SOUTH YOSEMITE
Practice Address - Street 2:SUITE 327
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2888
Practice Address - Country:US
Practice Address - Phone:303-671-0761
Practice Address - Fax:720-881-7446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COH 01 1 053921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty