Provider Demographics
NPI:1487721759
Name:KUYRKENDALL, LEIGH CARTER (DMD)
Entity type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:CARTER
Last Name:KUYRKENDALL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N WATAUGA LANE
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37350
Mailing Address - Country:US
Mailing Address - Phone:423-821-7508
Mailing Address - Fax:423-821-5432
Practice Address - Street 1:120 N WATAUGA LN
Practice Address - Street 2:
Practice Address - City:LOOKOUT MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37350-1375
Practice Address - Country:US
Practice Address - Phone:423-821-7508
Practice Address - Fax:423-821-5432
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN97911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice