Provider Demographics
NPI:1972572279
Name:LEY, JOHN C (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:LEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2575 MONTEBELLO DR WEST
Mailing Address - Street 2:#203
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:719-598-8886
Mailing Address - Fax:719-598-0531
Practice Address - Street 1:2575 MONTEBELLO DR WEST
Practice Address - Street 2:#203
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-598-8886
Practice Address - Fax:719-598-0531
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO245122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist