Provider Demographics
NPI:1275794216
Name:LE, HUONG T (DMD)
Entity Type:Individual
Prefix:DR
First Name:HUONG
Middle Name:T
Last Name:LE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:2115 SE 192ND AVE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7444
Mailing Address - Country:US
Mailing Address - Phone:360-817-2747
Mailing Address - Fax:360-817-2717
Practice Address - Street 1:2115 SE 192ND AVE
Practice Address - Street 2:SUITE #102
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7444
Practice Address - Country:US
Practice Address - Phone:360-817-2747
Practice Address - Fax:360-817-2717
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2015-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORD74981223X0400X
WADE 000099061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics