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General NPI Number Information
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NPI Number | 1174831788
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Entity Type | Organization
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Legal Business Name | BRIAN LEY, D.D.S., INC.
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 1966 E CHAPMAN AVE STE E
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City | FULLERTON
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State | CA
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Zip | 92831-4142
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Country | US
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Telephone | 714-725-7425
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Fax |
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Provider Business Mailing Address
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Address Line | 1966 E CHAPMAN AVE STE E
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City | FULLERTON
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State | CA
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Zip | 92831-4142
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Country | US
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Telephone | 714-725-7425
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST/OWNER
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Name | DR. BRIAN LEY
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Credential | D.D.S.
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Telephone | 714-725-7425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | BT30033119
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License Number State | CA
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