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General NPI Number Information
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NPI Number | 1629540513
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Entity Type | Organization
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Legal Business Name | LE & LE DENTAL CORPORATION
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 06/22/2024
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Provider Practice Location Address
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Address Line | 3643 GRAND AVE STE A
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City | SAN MARCOS
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State | CA
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Zip | 92078-2336
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Country | US
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Telephone | 760-536-3648
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Fax | 760-734-5762
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Provider Business Mailing Address
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Address Line | 3643 GRAND AVE STE A
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City | SAN MARCOS
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State | CA
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Zip | 92078-2336
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Country | US
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Telephone | 760-536-3648
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Fax | 760-734-5762
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | VINH BAO LE
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Credential | DDS
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Telephone | 760-591-9494
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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 |
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License Number State |
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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 |
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License Number State |
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