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NPI Code Detail

MEDICARE: CHRISTINE P LE D.D.S.

MEDICARE: CHRISTINE P LE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry26529TX

General Provider Information

NPI Number : 1245518471
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE P LE D.D.S.
Provider Business Mailing Address
First Line : 2815 AZLE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76106-5106
Country : US
Telephone Number : 817-624-0222
Fax Number : 817-624-0221
Provider Business Practice Location Address
First Line : 2815 AZLE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76106-5106
Country : US
Telephone Number : 817-624-0222
Fax Number : 817-624-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2011
Last Update Date : 08/21/2012

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Directions to “ CHRISTINE P LE D.D.S.” Practice Location

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