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General NPI Number Information
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NPI Number | 1477663789
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Entity Type | Organization
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Legal Business Name | NGUYEN & LE DENTAL CORP
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2508 OAKDALE RD STE B4
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-551-6988
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Fax | 209-551-6840
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Provider Business Mailing Address
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Address Line | 2508 OAKDALE RD STE B4
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-551-6988
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Fax | 209-551-6840
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Authorized Official
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Title or Position | DENTIST
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Name | DR. YVONNE PY LE
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Credential | DDS
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Telephone | 209-551-6988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52900
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 51609
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License Number State | CA
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