MEDICARE: DR. ANN NGOCAN 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
1	1223G0001X	General Practice Dentistry	19652	TX

General Provider Information

NPI Number	:	1902945074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN NGOCAN LE D.D.S.

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	:	832-237-2255

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	:	832-237-2255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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