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General NPI Number Information
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NPI Number | 1578762415
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Entity Type | Organization
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Legal Business Name | DIEN T LE OD PC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 4500 W 38TH AVE #130
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City | DENVER
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State | CO
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Zip | 80212-2001
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Country | US
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Telephone | 303-455-0888
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Fax | 303-455-0300
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Provider Business Mailing Address
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Address Line | 4500 W 38TH AVE #130
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City | DENVER
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State | CO
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Zip | 80212-2001
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Country | US
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Telephone | 303-455-0888
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Fax | 303-455-0300
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DIEN TRUY LE
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Credential | O.D.
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Telephone | 303-455-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2512
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License Number State | CO
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