Provider Demographics
NPI:1205090180
Name:KOBREN, LEONARD BRUCE (DDS)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:BRUCE
Last Name:KOBREN
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 1:12 OLD MAMARONECK RD STE 1C
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2025
Mailing Address - Country:US
Mailing Address - Phone:914-948-7177
Mailing Address - Fax:914-289-1731
Practice Address - Street 1:12 OLD MAMARONECK RD STE 1C
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2025
Practice Address - Country:US
Practice Address - Phone:914-948-7177
Practice Address - Fax:914-289-1731
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0299191223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics