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General NPI Number Information
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NPI Number | 1831408087
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Entity Type | Organization
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Legal Business Name | YEN V, LE, D.D.S., P.C.
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | 4216 EVERGREEN LN STE 113
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City | ANNANDALE
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State | VA
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Zip | 22003-3253
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Country | US
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Telephone | 703-941-2763
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Fax | 703-941-2763
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Provider Business Mailing Address
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Address Line | 4216 EVERGREEN LN STE 113
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City | ANNANDALE
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State | VA
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Zip | 22003-3253
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Country | US
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Telephone | 703-941-2763
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Fax | 703-941-2763
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YEN VAN LE
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Credential | D.D.S
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Telephone | 703-941-2763
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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 | 0401410716
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License Number State | VA
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