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General NPI Number Information
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NPI Number | 1730227240
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Entity Type | Organization
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Legal Business Name | QUANG LE DDS PA
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 894 E WARNER RD #105
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City | GILBERT
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State | AZ
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Zip | 85296
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Country | US
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Telephone | 480-882-9588
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Fax | 480-813-6100
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Provider Business Mailing Address
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Address Line | 894 E WARNER RD STE #105
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City | GILBERT
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State | AZ
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Zip | 85296
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Country | US
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Telephone | 480-882-9588
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Fax | 480-813-6100
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Authorized Official
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Title or Position | DENTIST PRESIDENT
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Name | QUANG LE
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Credential | DDS
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Telephone | 480-882-9588
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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 | D5777
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License Number State | AZ
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