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NPI Code Detail

MEDICARE: MICHELLE TRAN LEONG DDS

MEDICARE:   MICHELLE TRAN LEONG  DDS
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
1122300000XDentist60642CA

General Provider Information

NPI Number : 1841569738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE TRAN LEONG DDS
Provider Business Mailing Address
First Line : 16650 HIGHWAY 76
Second Line : PO BOX 655
City : PAUMA VALLEY
State : CA
Zip : 92061-9524
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 16650 HIGHWAY 76
Second Line :
City : PAUMA VALLEY
State : CA
Zip : 92061-9524
Country : US
Telephone Number : 760-742-0672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2011
Last Update Date : 12/02/2015

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Directions to “ MICHELLE TRAN LEONG DDS” Practice Location

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