| NPI | 1811251036 | 
|---|---|
| Former Name | LEANNA CHRISTINE ASSID | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS039199)  | 
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 8184)  | 
| Enumeration Date | 2012-07-02 | 
| Last Update Date | 2024-02-19 |