Provider Demographics
NPI:1174613921
Name:BORDADOR, LEONARDO CARLOS FERRER (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:LEONARDO CARLOS
Middle Name:FERRER
Last Name:BORDADOR
Suffix:
Gender:M
Credentials:DMD, MS
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Mailing Address - Street 1:2737 LAGUNA SECA AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4428
Mailing Address - Country:US
Mailing Address - Phone:310-936-4382
Mailing Address - Fax:
Practice Address - Street 1:2799 SUNRIDGE HEIGHTS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5055
Practice Address - Country:US
Practice Address - Phone:702-878-2799
Practice Address - Fax:702-436-2799
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0532001223X0400X
NVS3-193C1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics