Leak, Amanda Marie

Leak, Amanda Marie is an individual health care provider with primary practice located at 1055 E Stewart Ave Bldg 2018 , Peterson Afb CO 80914-2900. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Leak, Amanda Marie can be contacted via phone (719) 556-1333.

Contact Information

Primary practice address
1055 E Stewart Ave Bldg 2018 Peterson Afb CO 80914-2900
Phone: (719) 556-1333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X

Profile Details

NPI number 1093305146
LBN Legal business name Leak, Amanda Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2021
Last updated Jan 22nd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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