Provider Demographics
NPI:1023234556
Name:LEIGH, ROBERT A (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:LEIGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3211 BENNETT POINT RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21658-1126
Mailing Address - Country:US
Mailing Address - Phone:410-827-8054
Mailing Address - Fax:410-827-2855
Practice Address - Street 1:104 FORBES ST
Practice Address - Street 2:SUITE 203
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1516
Practice Address - Country:US
Practice Address - Phone:410-268-4945
Practice Address - Fax:410-268-0426
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD46961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice