Provider Demographics
NPI:1720246648
Name:STONE HIRSH, LESLIE STONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:STONE
Last Name:STONE HIRSH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:STONE
Other - Last Name:HIRSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1420 LOCUST STREET
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-732-9171
Mailing Address - Fax:215-545-0892
Practice Address - Street 1:1420 LOCUST STREET
Practice Address - Street 2:SUITE 120
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-732-9171
Practice Address - Fax:215-545-0892
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026147L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics