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General NPI Number Information
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NPI Number | 1659942639
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Entity Type | Individual
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Provider Name | DUC LE DMD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 242 S FINLEY RD
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City | LOMBARD
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State | IL
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Zip | 60148-2425
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Country | US
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Telephone | 832-661-0172
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Fax |
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Provider Business Mailing Address
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Address Line | 7019 PLUM CREEK TRAIL LN
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City | HOUSTON
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State | TX
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Zip | 77087-2565
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Country | US
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Telephone | 832-661-0172
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 37595
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License Number State | TX
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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 | 26064
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019034233
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License Number State | IL
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