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NPI Code Detail

MEDICARE: BRIDGET LE

MEDICARE: BRIDGET LE
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 Dentistry32988TX

General Provider Information

NPI Number : 1528588753
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET LE
Provider Business Mailing Address
First Line : 7936 XAVIER CT
Second Line :
City : DALLAS
State : TX
Zip : 75218-4512
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3237 DAWES DR
Second Line :
City : DALLAS
State : TX
Zip : 75211-5760
Country : US
Telephone Number : 214-333-3335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2017
Last Update Date : 06/20/2017

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Directions to “ BRIDGET LE ” Practice Location

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