Healthcare Provider Details

I. General information

NPI: 1932289873
Provider Name (Legal Business Name): LEH-HA LUCIA CHEW DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEH-HA LUCIA KIEW

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 US1 SOUTH
ST. AUGUSTINE FL
32086
US

IV. Provider business mailing address

1313 KILLBRICKEN CIR
ORMOND BEACH FL
32174-3087
US

V. Phone/Fax

Practice location:
  • Phone: 904-825-5058
  • Fax:
Mailing address:
  • Phone: 386-615-0612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDTC102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: