Provider Demographics
NPI:1932247350
Name:SALTZMAN, LEONARD ERWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ERWIN
Last Name:SALTZMAN
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 1:225 E DEERPATH RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-1952
Mailing Address - Country:US
Mailing Address - Phone:847-295-2555
Mailing Address - Fax:847-295-2582
Practice Address - Street 1:225 E DEERPATH RD
Practice Address - Street 2:SUITE 290
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1952
Practice Address - Country:US
Practice Address - Phone:847-295-2555
Practice Address - Fax:847-295-2582
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry