Provider Demographics
NPI:1700854098
Name:MCCALL, LELAND (DDS)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:
Last Name:MCCALL
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 1:4301 DONIPHAN DR
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-9120
Mailing Address - Country:US
Mailing Address - Phone:417-845-2273
Mailing Address - Fax:417-845-8318
Practice Address - Street 1:927 N BUSINESS HWY 71
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:MO
Practice Address - Zip Code:64831
Practice Address - Country:US
Practice Address - Phone:417-845-2273
Practice Address - Fax:417-845-8318
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO015188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist