Leavitt Family and Cosmetic Dentistry

NPI #1528227121 in Pocatello, Idaho

Provider Information

NPI Number: 1528227121
Entity Type: Organization
Organization Name: Leavitt Family and Cosmetic Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 9, 2008
Last Updated: Jun 25, 2008

Practice Location

Address: 333 W CEDAR ST
City: Pocatello
State: Idaho
ZIP Code: 83201
Phone: (208) 233-6900

Authorized Official

Name: DR. CASEY J. LEAVITT, DDS PA
Title: DR
Phone: (208) 233-6900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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