Provider Demographics
NPI:1316958424
Name:MENAPACE, LEON MICHAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:MICHAEL
Last Name:MENAPACE
Suffix:
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 1:2 UTAH DR
Mailing Address - Street 2:
Mailing Address - City:KULPMONT
Mailing Address - State:PA
Mailing Address - Zip Code:17834-1972
Mailing Address - Country:US
Mailing Address - Phone:570-373-5563
Mailing Address - Fax:570-373-5562
Practice Address - Street 1:2 UTAH DR
Practice Address - Street 2:
Practice Address - City:KULPMONT
Practice Address - State:PA
Practice Address - Zip Code:17834-1972
Practice Address - Country:US
Practice Address - Phone:570-373-5563
Practice Address - Fax:570-373-5562
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020642L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice