Provider Demographics
NPI:1902242829
Name:LEDDY, CYRIL V JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:V
Last Name:LEDDY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1607
Mailing Address - Country:US
Mailing Address - Phone:610-372-7218
Mailing Address - Fax:610-372-7595
Practice Address - Street 1:312 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1607
Practice Address - Country:US
Practice Address - Phone:610-372-7218
Practice Address - Fax:610-372-7595
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020420-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist