Provider Demographics
NPI:1134200397
Name:SMITH, LEANNE THUNE (DDS)
Entity type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:THUNE
Last Name:SMITH
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 1:2281 S RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-5223
Mailing Address - Country:US
Mailing Address - Phone:225-664-7011
Mailing Address - Fax:225-664-7011
Practice Address - Street 1:2281 S RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-5223
Practice Address - Country:US
Practice Address - Phone:225-664-7011
Practice Address - Fax:225-667-5893
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice