Provider Demographics
NPI:1598818676
Name:LEINGANG, MICHAEL LOUIS III (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:LEINGANG
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1136 TALIWA TRAIL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-6278
Mailing Address - Country:US
Mailing Address - Phone:770-977-1892
Mailing Address - Fax:678-560-5261
Practice Address - Street 1:1136 TALIWA TRAIL
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-6278
Practice Address - Country:US
Practice Address - Phone:770-977-1892
Practice Address - Fax:678-560-5261
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0122851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice