Provider Demographics
NPI:1962996082
Name:LEAHEY, HANNAH (DMD)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:LEAHEY
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 1:3 WALLACE RD
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1425
Mailing Address - Country:US
Mailing Address - Phone:508-347-9336
Mailing Address - Fax:508-347-5072
Practice Address - Street 1:3 WALLACE RD
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1425
Practice Address - Country:US
Practice Address - Phone:508-347-9336
Practice Address - Fax:508-347-5072
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18580131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice