Provider Demographics
NPI:1831245539
Name:ARCA, LEANDRO SANTOS (DDS)
Entity type:Individual
Prefix:DR
First Name:LEANDRO
Middle Name:SANTOS
Last Name:ARCA
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 1:917 S MULLEN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1829
Mailing Address - Country:US
Mailing Address - Phone:213-324-8483
Mailing Address - Fax:323-583-4237
Practice Address - Street 1:2711 SANTA ANA ST
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-2021
Practice Address - Country:US
Practice Address - Phone:323-583-2385
Practice Address - Fax:323-583-4237
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice