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General NPI Number Information
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NPI Number | 1568607695
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Entity Type | Individual
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Provider Name | QUOC-ALBERT D LE DDS
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Gender | Male
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 7916 S BROADWAY AVE STE 150
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City | TYLER
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State | TX
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Zip | 75703-5287
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Country | US
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Telephone | 903-581-2198
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Fax |
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Provider Business Mailing Address
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Address Line | 316 BRIDLE RIDGE CT
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City | TYLER
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State | TX
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Zip | 75703-1254
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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 |
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Name |
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Credential |
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Telephone |
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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 | 62525
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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 | 24360
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License Number State | TX
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