Provider Demographics
NPI:1104347772
Name:STELLY, LEAH CHRYSTENE (DDS)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:CHRYSTENE
Last Name:STELLY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 COIT RD STE 700
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5946
Mailing Address - Country:US
Mailing Address - Phone:972-867-2500
Mailing Address - Fax:
Practice Address - Street 1:5800 COIT RD STE 700
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5946
Practice Address - Country:US
Practice Address - Phone:972-867-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33181122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist