Provider Demographics
NPI:1952746620
Name:TALBERT, LESLIE MCNEIL (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:MCNEIL
Last Name:TALBERT
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 CLUBHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3415
Mailing Address - Country:US
Mailing Address - Phone:251-968-1310
Mailing Address - Fax:
Practice Address - Street 1:241 CLUBHOUSE DR
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3415
Practice Address - Country:US
Practice Address - Phone:251-968-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL57521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics