Provider Demographics
NPI:1184713976
Name:LEIGH, DOUGLAS F (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:F
Last Name:LEIGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KILGORE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2153
Mailing Address - Country:US
Mailing Address - Phone:978-302-3803
Mailing Address - Fax:
Practice Address - Street 1:380 ELM ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3935
Practice Address - Country:US
Practice Address - Phone:978-630-1702
Practice Address - Fax:978-630-2450
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice