Provider Demographics
NPI:1184806408
Name:BUCKHEIT, LEONARD ROBERT II (DDS)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ROBERT
Last Name:BUCKHEIT
Suffix:II
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 1:4102 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1641
Mailing Address - Country:US
Mailing Address - Phone:410-235-1299
Mailing Address - Fax:
Practice Address - Street 1:4102 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1641
Practice Address - Country:US
Practice Address - Phone:410-235-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6387122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist