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NPI 1790724813

NPI 1790724813 : THANG QUOC LE D.D.S. : BAY PINES, FL

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General NPI Number Information
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    NPI Number           |    1790724813
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    Entity Type          |    Individual 
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    Provider Name        |    THANG QUOC LE D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/05/2006
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    Last Update Date     |    08/15/2023
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Provider Practice Location Address
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    Address Line         |    10000 BAY PINES BLVD 
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    City                 |    BAY PINES
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    State                |    FL
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    Zip                  |    33744-8200
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    Country              |    US
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    Telephone            |    910-964-0315
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    Fax                  |    941-721-6080
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Provider Business Mailing Address
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    Address Line         |    10000 BAY PINES BLVD 
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    City                 |    BAY PINES
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    State                |    FL
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    Zip                  |    33744-8200
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    Country              |    US
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    Telephone            |    910-964-0315
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    7376
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    License Number State |    NC
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