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General NPI Number Information
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NPI Number | 1689834723
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Entity Type | Individual
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Provider Name | BAO-QUYEN THI LE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2008
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 1531 MARYLAND AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20002-7604
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Country | US
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Telephone | 202-470-1126
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Fax | 202-399-0130
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Provider Business Mailing Address
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Address Line | 10713 ALMOND ST
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City | FAIRFAX
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State | VA
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Zip | 22032-3402
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Country | US
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Telephone | 703-232-6672
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Fax | 703-691-0740
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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 | 0401412048
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License Number State | VA
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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 | DEN1000752
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License Number State | DC
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