Provider Demographics
NPI:1558798223
Name:MICHAEL K. LE, DDS, INC
Entity Type:Organization
Organization Name:MICHAEL K. LE, DDS, INC
Other - Org Name:YOURDENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-826-5000
Mailing Address - Street 1:3174 W LINCOLN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-6085
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3174 W LINCOLN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6085
Practice Address - Country:US
Practice Address - Phone:714-826-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47509122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty