Organization Name: | JASMINE H. LE D.D.S., INC. |
NPI Number: | 1013392422 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASMINE HOANG LE (PRESIDENT) |
Mailing Address: | 166 Main St Suite #1 Los Altos |
State: | CA US |
Postal Code: | 940222905 |
Phone Number: | 6505591996 |
Fax Number: | 4087367987 |
NPI Enumeration Date: | 07/27/2015 |
NPI Last Update Date: | 09/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 51670 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |