Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 5225 | NC |
NPI | 1528236429 |
---|---|
Provider Name | Dr. Thomas M Leiendecker |
First Address | Bethesda, MD 20814-4799 |
Second Address | Bethesda, MD 20814-4799 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 13/02/2008 |