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General NPI Number Information
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NPI Number | 1700919370
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Entity Type | Organization
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Legal Business Name | LINDA TU LE DDS INC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 2160 W GRANT LINE RD STE 245
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City | TRACY
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State | CA
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Zip | 95377-7335
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Country | US
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Telephone | 209-834-0572
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Fax | 209-834-0582
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Provider Business Mailing Address
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Address Line | 2160 W GRANT LINE RD STE 245
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City | TRACY
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State | CA
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Zip | 95377-7335
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Country | US
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Telephone | 209-834-0572
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Fax | 209-834-0582
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. PHACH N NGUYEN
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Credential |
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Telephone | 209-574-9600
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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 | 45725
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License Number State | CA
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