Amanda Marie Leak
Dental Assistant
1055 E Stewart Ave Bldg 2018
Peterson Afb
, Colorado 80914-2900
Amanda Marie Leak
Dental Assistant
1055 E Stewart Ave Bldg 2018
Peterson Afb
, Colorado 80914-2900
(406) 868-0180
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About
Features
Specialties
- Dental Assistant
Languages spoken
- English
Location
First Address
- Amanda Marie Leak
- 5055 Sodbuster Trl
- Colorado Springs, CO
- Zip : 80917-1715
- Phone : (406) 868-0180
Second Address
- Amanda Marie Leak
- 1055 E Stewart Ave Bldg 2018
- Peterson Afb, CO
- Zip : 80914-2900
- Phone : (719) 556-1333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 126800000X | Dental Assistant |
National Provider Identifier
| NPI | 1093305146 |
|---|---|
| Provider Name | Amanda Marie Leak |
| First Address | Colorado Springs, CO 80917-1715 |
| Second Address | Peterson Afb, CO 80914-2900 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/01/2021 |
| Last Update Date | 22/01/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.