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General NPI Number Information
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NPI Number | 1164345047
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Entity Type | Individual
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Provider Name | JACQUELINE LE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 3050 S UNIVERSITY DR.
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City | DAVIE
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State | FL
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Zip | 33314
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Country | US
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Telephone | 336-905-2585
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Fax |
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Provider Business Mailing Address
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Address Line | 4930 RANGER DR APT 1202
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City | DAVIE
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State | FL
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Zip | 33328-7159
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Country | US
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Telephone | 336-905-2585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32242
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License Number State | FL
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