Provider Demographics
NPI:1316967995
Name:LEBER, ERIC JOHN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOHN
Last Name:LEBER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1647 N ALVERNON WAY
Mailing Address - Street 2:SUITE #2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3361
Mailing Address - Country:US
Mailing Address - Phone:520-795-2323
Mailing Address - Fax:529-795-1703
Practice Address - Street 1:1647 N ALVERNON WAY
Practice Address - Street 2:SUITE #2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3361
Practice Address - Country:US
Practice Address - Phone:520-795-2323
Practice Address - Fax:529-795-1703
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD16441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics