Provider Demographics
NPI:1649281817
Name:DREISBACH, LESLEE RAKOWSKY (DMD)
Entity type:Individual
Prefix:DR
First Name:LESLEE
Middle Name:RAKOWSKY
Last Name:DREISBACH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 ALLEN STREET
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4363
Mailing Address - Country:US
Mailing Address - Phone:610-435-2610
Mailing Address - Fax:610-435-7065
Practice Address - Street 1:2250 ALLEN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4363
Practice Address - Country:US
Practice Address - Phone:610-435-2610
Practice Address - Fax:610-435-7065
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0273906122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist