Brian K. Leach, D.D.S.
Individual provider Active NPI General Practice Dentistry · Shell Knob, MO
NPI 1104038074 · NPPES record last updated Jun 10, 2010
Key facts
- NPI
- 1104038074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3452 (AR)
- Practice address
- 25376 State Highway 39
Suite 201
Shell Knob, MO 65747-7343 - Phone
- (417) 858-6527
- Fax
- (417) 858-2570
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3452 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian K. Leach, D.D.S. | General Practice | Past | Accepting new patients |
| Brian K. Leach DDS LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3452 | AR | Yes |
Addresses
Primary practice location
25376 State Highway 39
Suite 201
Shell Knob, MO 65747-7343
Mailing address
25376 State Highway 39 Ste 201
P.O. Box 226
Shell Knob, MO 65747-7900
Phone (417) 858-6527
Other providers in Shell Knob, MO
- Randy Jackson Curl
- Georgann Marie Greissinger
- Aaron Guyer
- Patrick B. Harr
- Jillian A Hodge
- Lester E Cox Medical Centers
- Lester E. Cox Medical Centers
- Robert Eugene McDougle
- Mercy Clinic-Springfield Communities
- Mercy Hospital Springfield
All providers in Shell Knob, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.