MEDICARE: ANN LE DDS PA

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
1	1223G0001X	General Practice Dentistry	19652	TX

General Provider Information

NPI Number	:	1710201462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANN LE DDS PA

Provider Business Mailing Address
First Line	:	12432 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4809
Country	:	US
Telephone Number	:	832-237-4444
Fax Number	:	832-237-4444

Provider Business Practice Location Address
First Line	:	12432 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4809
Country	:	US
Telephone Number	:	832-237-4444
Fax Number	:	832-237-4444

Authorized Official
Title or Position	:	DDS/PRESIDENT
Name	:	ANN NGOCAN LE
Credential	:	DDS
Telephone Number	:	832-237-4444

Provider Enumeration Date	:	03/24/2010
Last Update Date	:	03/24/2010

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