Provider Demographics
NPI:1952710949
Name:RYAN M LEONHART DDS MD PLLC
Entity Type:Organization
Organization Name:RYAN M LEONHART DDS MD PLLC
Other - Org Name:SOUTH TEXAS ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONHART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:210-625-7277
Mailing Address - Street 1:6530 W LOOP 1604 N
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6319
Mailing Address - Country:US
Mailing Address - Phone:210-625-7277
Mailing Address - Fax:210-787-2022
Practice Address - Street 1:6530 W LOOP 1604 N
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-6319
Practice Address - Country:US
Practice Address - Phone:210-625-7277
Practice Address - Fax:210-787-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX277201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty