Whalio Doctors

NPI 1093305146

Amanda Marie Leak

Practitioner Dental Assistant Peterson Afb, CO

Practice location

Address
1055 E Stewart Ave Bldg 2018, Peterson Afb, CO 80914-2900
Phone
(719) 556-1333
Mailing address
5055 Sodbuster Trl, Colorado Springs, CO 80917-1715

Registered specialties

Dental Assistant Primary
Dental Providers Taxonomy 126800000X

Registry record

NPI
1093305146
Entity type
Individual
Sex (as registered)
Female
NPI issued
22 Jan 2021
Record last updated
22 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.