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General NPI Number Information
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NPI Number | 1134520943
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Entity Type | Organization
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Legal Business Name | LLUAN T. LE, DDS, INC
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Dates
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Enumeration Date | 09/11/2014
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 3151 S WHITE RD STE 204
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City | SAN JOSE
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State | CA
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Zip | 95148-4045
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Country | US
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Telephone | 408-270-1120
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Fax | 408-270-1026
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Provider Business Mailing Address
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Address Line | 3151 S WHITE RD STE 204
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City | SAN JOSE
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State | CA
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Zip | 95148-4045
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Country | US
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Telephone | 408-270-1120
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Fax | 408-270-1026
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. LUAN TRAN LE
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Credential | DDS
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Telephone | 408-270-1120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 39029
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License Number State | CA
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