MEDICARE: HAO ANH LE DDS INC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1912476524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAO ANH LE DDS INC

Provider Business Mailing Address
First Line	:	14341 BEACH BLVD STE I
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4561
Country	:	US
Telephone Number	:	714-896-0793
Fax Number	:

Provider Business Practice Location Address
First Line	:	14341 BEACH BLVD STE I
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4561
Country	:	US
Telephone Number	:	714-896-0793
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HAO ANH LE
Credential	:	DDS
Telephone Number	:	480-206-4358

Provider Enumeration Date	:	11/13/2018
Last Update Date	:	11/13/2018

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