MEDICARE: DR. PHUONG-UYEN LE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN 17922	FL

General Provider Information

NPI Number	:	1437350998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHUONG-UYEN LE DMD

Provider Business Mailing Address
First Line	:	7123 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-5250
Country	:	US
Telephone Number	:	813-932-7939
Fax Number	:

Provider Business Practice Location Address
First Line	:	7123 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-5250
Country	:	US
Telephone Number	:	813-932-7939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	01/11/2012

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