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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. LEONARD RAY FUQUA JR., DDS, MS

Active Sole Proprietor

DR. LEONARD RAY FUQUA JR., DDS, MS is a Orthodontics healthcare provider located in KINGSTON, Tennessee. NPI 1063493500 is currently active in the NPPES registry. Verify at CMS.

Orthodontics · KINGSTON, TN

Registration Details

NPI Number
1063493500
Provider Type
Individual
Gender
Male
NPI Issued
Nov 10, 2005 (20.719620055078 yrs)
Last Updated
Jul 5, 2011
License
DS0000002917 (TN)
Sole Proprietor
Yes

Practice Information

Address
505 N KENTUCKY ST
KINGSTON, TN, 377632630
Browse TN providers · Browse ZIP 37763
Phone
8653764445
Fax
8653764441
Primary Specialty
Orthodontics
1223X0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.