Leslie Paul Midla, D.D.S.
Individual provider Active NPI General Practice Dentistry · Beallsville, PA
NPI 1902018278 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1902018278
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS-17664-L (PA)
- Practice address
- 2842 Main Street
Beallsville, PA 15313 - Phone
- (724) 632-3350
- Fax
- (724) 632-3360
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| DS-17664-L | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS-17664-L | PA | Yes |
Addresses
Primary practice location
2842 Main Street
Beallsville, PA 15313
Mailing address
2842 Main Street
P.O. Box 39
Beallsville, PA 15313
Phone (724) 632-3350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1147108184 Y J | Other | PA | ADA NUMBER |
Other providers in Beallsville, PA
All providers in Beallsville, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.