Provider Demographics
NPI:1952721714
Name:JOEL A LEONARD DMD
Entity Type:Organization
Organization Name:JOEL A LEONARD DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUSHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-659-4034
Mailing Address - Street 1:334 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1756
Mailing Address - Country:US
Mailing Address - Phone:781-659-4034
Mailing Address - Fax:781-659-4080
Practice Address - Street 1:334 WASHINGTON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1756
Practice Address - Country:US
Practice Address - Phone:781-659-4034
Practice Address - Fax:781-659-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13338122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty