Provider Demographics
NPI:1447348354
Name:LEACH, STEVEN ALEXANDER SR (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALEXANDER
Last Name:LEACH
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6021
Mailing Address - Country:US
Mailing Address - Phone:256-353-3211
Mailing Address - Fax:256-353-4345
Practice Address - Street 1:2002 FLINT RD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6021
Practice Address - Country:US
Practice Address - Phone:256-353-3211
Practice Address - Fax:256-353-4345
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice