Provider Demographics
NPI:1629117304
Name:HUYNH LE, MAI (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAI
Middle Name:
Last Name:HUYNH LE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2189 CLEVELAND ST SUITE 252
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3213
Mailing Address - Country:US
Mailing Address - Phone:727-461-9149
Mailing Address - Fax:727-446-8382
Practice Address - Street 1:2189 CLEVELAND ST SUITE 252
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3213
Practice Address - Country:US
Practice Address - Phone:727-461-9149
Practice Address - Fax:727-446-8382
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist