CASEY JON LEAVITT

POCATELLO, ID
NPI1952495491
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D3630)
Enumeration Date2006-10-02
Last Update Date2007-07-08
Business Address
Dr. CASEY JON LEAVITT DDS
333 W. CEDAR
POCATELLO, ID 83201-5045
Phone number: 208-233-6900
Mailing Address
Dr. CASEY JON LEAVITT DDS
333 W. CEDAR
POCATELLO, ID 83201-5045
Phone number: 208-233-6900
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