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General NPI Number Information
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NPI Number | 1972861086
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Entity Type | Organization
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Legal Business Name | CAROLINE LE, DDS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 9946 ALABAMA ST
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City | REDLANDS
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State | CA
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Zip | 92374-2036
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Country | US
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Telephone | 909-748-7149
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Fax |
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Provider Business Mailing Address
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Address Line | 9946 ALABAMA ST
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City | REDLANDS
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State | CA
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Zip | 92374-2036
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/ DENTIST
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Name | DR. CAROLINE LE
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Credential | DDS
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Telephone | 909-748-7149
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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 | 48306
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License Number State | CA
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