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General NPI Number Information
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NPI Number | 1396072930
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Entity Type | Organization
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Legal Business Name | ADVANCED MICROENDODONTICS, PC
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 6217 CHAPEL HILL BLVD STE 107
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City | PLANO
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State | TX
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Zip | 75093-1609
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Country | US
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Telephone | 972-403-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 6217 CHAPEL HILL BLVD STE 107
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City | PLANO
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State | TX
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Zip | 75093-1609
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Country | US
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Telephone | 972-403-8000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LE YEN THI O'LEARY
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Credential |
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Telephone | 972-403-8000
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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 | 16987
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License Number State | TX
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