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General NPI Number Information
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NPI Number | 1881041853
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Entity Type | Organization
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Legal Business Name | LE-NGUYEN, D.M.D., P.C.
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 119 POTTERY FACTORY DRIVE
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City | COMMERCE
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State | GA
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Zip | 30529
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Country | US
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Telephone | 706-336-8318
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Fax |
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Provider Business Mailing Address
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Address Line | 119 POTTERY FACTORY DRIVE
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City | COMMERCE
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State | GA
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Zip | 30529
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Country | US
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Telephone | 706-336-8318
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HA NGOC LE
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Credential | D.M.D.
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Telephone | 706-336-8318
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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 | DN013713
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License Number State | GA
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