Provider Demographics
NPI:1568784239
Name:HA NGOC LE, D.M.D., PC
Entity Type:Organization
Organization Name:HA NGOC LE, D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HA
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:706-336-8318
Mailing Address - Street 1:119 POTTERY FACTORY DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-6679
Mailing Address - Country:US
Mailing Address - Phone:706-336-8318
Mailing Address - Fax:706-336-8315
Practice Address - Street 1:119 POTTERY FACTORY DR
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-6679
Practice Address - Country:US
Practice Address - Phone:706-336-8318
Practice Address - Fax:706-336-8315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0137131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty