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Provider Information for 1396834362

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DR. MARC ERNEST LEBLANC D.D.S.

Gender: MALE

Individual NPI: 1396834362

Calendar   Last Updated:  2010-07-28
  Certification Date: 

Details

Name Value
NPI 1396834362
Enumeration Date 2006-10-11
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 44853 PORTOLA AVE SUITE B
PALM DESERT, CA 92260-3703
United States

Phone: 760-346-1414 | Fax: 760-346-7335
View Map External Link
Primary Practice Address 44853 PORTOLA AVE SUITE B
PALM DESERT, CA 92260-3703
United States

Phone: 760-346-1414 | Fax: 760-346-7335
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other TAX ID # CA 200418543
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 36169