Provider Demographics
NPI:1073049177
Name:LE, LAM ANH (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAM
Middle Name:ANH
Last Name:LE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9028 DOWDEN RD
Mailing Address - Street 2:APT 319
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-6805
Mailing Address - Country:US
Mailing Address - Phone:407-520-7716
Mailing Address - Fax:
Practice Address - Street 1:9028 DOWDEN RD
Practice Address - Street 2:APT 319
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-6805
Practice Address - Country:US
Practice Address - Phone:407-520-7716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist