Provider Demographics
NPI:1104968619
Name:JULIAN C LEICHTER DMD PA
Entity type:Organization
Organization Name:JULIAN C LEICHTER DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LEICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-998-9988
Mailing Address - Street 1:7000 WEST CAMINO REAL
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5532
Mailing Address - Country:US
Mailing Address - Phone:561-391-1800
Mailing Address - Fax:561-391-1801
Practice Address - Street 1:7000 WEST CAMINO REAL
Practice Address - Street 2:SUITE 120
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5532
Practice Address - Country:US
Practice Address - Phone:561-391-1800
Practice Address - Fax:561-391-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty