Provider Demographics
NPI:1780870287
Name:LEON, JAMES T (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:LEON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 MARION MOUNT GILEAD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5913
Mailing Address - Country:US
Mailing Address - Phone:740-725-8000
Mailing Address - Fax:740-725-8020
Practice Address - Street 1:1677 MARION MOUNT GILEAD RD STE 300
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5913
Practice Address - Country:US
Practice Address - Phone:740-725-8000
Practice Address - Fax:740-725-8020
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18705122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist