Provider Demographics
NPI:1942472568
Name:H BARRY LESLIE DDS PA
Entity Type:Organization
Organization Name:H BARRY LESLIE DDS PA
Other - Org Name:H BARRY LESLIE DDS PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:H
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-692-7761
Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28388
Mailing Address - Country:US
Mailing Address - Phone:910-692-7761
Mailing Address - Fax:910-692-7471
Practice Address - Street 1:700 SW BROAD ST
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387
Practice Address - Country:US
Practice Address - Phone:910-692-7761
Practice Address - Fax:910-692-7471
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:H BARRY LESLIE DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty