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General NPI Number Information
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NPI Number | 1427479302
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Entity Type | Organization
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Legal Business Name | THANH HA LE, DDS PLLC
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 2320 E BASELINE RD STE 160
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City | PHOENIX
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State | AZ
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Zip | 85042-6951
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Country | US
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Telephone | 602-243-6900
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Fax | 602-243-6902
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Provider Business Mailing Address
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Address Line | 2320 E BASELINE RD STE 160
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City | PHOENIX
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State | AZ
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Zip | 85042-6951
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Country | US
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Telephone | 602-243-6900
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Fax | 602-243-6902
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Authorized Official
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Title or Position | OWNER
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Name | DR. THANH HA THI LE
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Credential | DDS
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Telephone | 602-243-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7057
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License Number State | AZ
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