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Provider Information for 1265952279



DR. LESLIE MARIE HARGIS-FULLER DDS

Gender: FEMALE

Individual NPI: 1265952279

Calendar Last Updated: 2017-06-21

Details

Name Value
NPI 1265952279
Enumeration Date 2017-06-21
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 294 E DAVIS ST
BURLINGTON, NC 27215-5819
United States

Phone: 226-226-8069 | Fax:
View Map External Link
Primary Practice Address 294 E DAVIS ST
BURLINGTON, NC 27215-5819
United States

Phone: 336-226-8069 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NC 10731