Provider Demographics
NPI:1568665479
Name:LE, TUAN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:A
Last Name:LE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 N. 44TH ST. #1009
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008
Mailing Address - Country:US
Mailing Address - Phone:619-905-2555
Mailing Address - Fax:
Practice Address - Street 1:822 E UNION HILLS DR
Practice Address - Street 2:D-6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-8403
Practice Address - Country:US
Practice Address - Phone:623-582-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD72341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice