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General NPI Number Information
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NPI Number | 1336457779
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Entity Type | Organization
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Legal Business Name | JUST DENTAL, PLLC
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 09/20/2010
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Provider Practice Location Address
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Address Line | 8433 FM 1464 RD STE B
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City | RICHMOND
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State | TX
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Zip | 77407-1102
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Country | US
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Telephone | 210-659-4572
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Fax |
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Provider Business Mailing Address
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Address Line | 8433 FM 1464 RD STE B
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City | RICHMOND
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State | TX
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Zip | 77407-1102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. ANH KIM LE
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Credential | D.D.S
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Telephone | 210-659-4572
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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 | 24051
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License Number State | TX
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