Provider Demographics
NPI:1235583832
Name:LE M. HO, D.D.S., P.A.
Entity Type:Organization
Organization Name:LE M. HO, D.D.S., P.A.
Other - Org Name:ROSEMOUNT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LE
Authorized Official - Middle Name:MANH
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-423-3993
Mailing Address - Street 1:14590 S ROBERT TRL
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-3195
Mailing Address - Country:US
Mailing Address - Phone:651-423-3993
Mailing Address - Fax:
Practice Address - Street 1:14590 S ROBERT TRL
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3195
Practice Address - Country:US
Practice Address - Phone:651-423-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND130301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND13030OtherLE M HO DDS