Provider Demographics
NPI:1942343611
Name:FLATTMANN, LEIGH SMITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:SMITH
Last Name:FLATTMANN
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 1:400 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9743
Mailing Address - Country:US
Mailing Address - Phone:985-845-8042
Mailing Address - Fax:
Practice Address - Street 1:400 PINE ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-9743
Practice Address - Country:US
Practice Address - Phone:985-845-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1857203Medicaid