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General NPI Number Information
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NPI Number | 1962180729
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Entity Type | Individual
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Provider Name | DR. TRI LE
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Gender | Male
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 610 PROFESSIONAL DR STE 250
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City | GAITHERSBURG
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State | MD
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Zip | 20879-3466
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Country | US
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Telephone | 301-963-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1824 WEBSTER ST
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City | BALTIMORE
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State | MD
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Zip | 21230-4755
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Country | US
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Telephone | 443-643-8246
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 17953
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License Number State | MD
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