Provider Demographics
NPI:1518492396
Name:QUYNHCHAU HOANG LE, DDS, INC.
Entity Type:Organization
Organization Name:QUYNHCHAU HOANG LE, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUYNHCHAU
Authorized Official - Middle Name:HOANG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-531-1192
Mailing Address - Street 1:9938 BOLSA AVE
Mailing Address - Street 2:# 106
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6039
Mailing Address - Country:US
Mailing Address - Phone:714-531-1192
Mailing Address - Fax:
Practice Address - Street 1:9938 BOLSA AVE
Practice Address - Street 2:# 106
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6039
Practice Address - Country:US
Practice Address - Phone:714-531-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37615122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty