Provider Demographics
NPI:1457369209
Name:LEISHMAN, AARON ALLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:ALLEN
Last Name:LEISHMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:AARON
Other - Middle Name:A
Other - Last Name:LEISHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD PA
Mailing Address - Street 1:9500 CORKSCREW PALMS CIRCLE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928
Mailing Address - Country:US
Mailing Address - Phone:239-947-7992
Mailing Address - Fax:239-949-9698
Practice Address - Street 1:9500 CORKSCREW PALMS CIRCLE
Practice Address - Street 2:SUITE 4
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928
Practice Address - Country:US
Practice Address - Phone:239-947-7992
Practice Address - Fax:239-949-9698
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist