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1649798935
JONATHAN BLAKE LEIST
CHARLOTTESVILLE, VA
NPI
1649798935
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: VA 0401415730)
Enumeration Date
2017-09-06
Last Update Date
2022-11-16
Business Address
Dr. JONATHAN BLAKE LEIST DDS
1138 ROSE HILL DR STE 400
CHARLOTTESVILLE, VA 22903-5128
Phone number: 434-972-6233
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Mailing Address
Dr. JONATHAN BLAKE LEIST DDS
2359 WHEATLANDS DR
MANAKIN SABOT, VA 23103-2134
Phone number: 757-812-2309
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