Leary, Susan
Leary, Susan is an individual health care provider with primary practice located at 3020 Children'S Way Mc#5127 , San Diego CA 92123-4223. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Leary, Susan can be contacted via phone (858) 966-4094.Contact Information
Primary practice address
3020 Children'S Way Mc#5127
San Diego CA 92123-4223
Phone: (858) 966-4094
Fax: (858) 966-8097
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 53671 | California |
Profile Details
| NPI number | 1477614717 |
|---|---|
| LBN Legal business name | Leary, Susan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477614717 | NPPES |
| California | MEDICAID | D53671 |
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