| NPI | 1154832400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THANH MINH LE Dentist 408-506-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52882) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 261QD0000X Clinic/Center, Dental (Licence: CA 52882) | |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2019-12-30 |