Provider Demographics
NPI:1871247254
Name:LE TI UY DMD, INC
Entity Type:Organization
Organization Name:LE TI UY DMD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:
Authorized Official - First Name:LE TI
Authorized Official - Middle Name:
Authorized Official - Last Name:UY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-448-7433
Mailing Address - Street 1:10411 LOWER AZUSA RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3470
Mailing Address - Country:US
Mailing Address - Phone:626-448-7433
Mailing Address - Fax:
Practice Address - Street 1:10411 LOWER AZUSA RD
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-3470
Practice Address - Country:US
Practice Address - Phone:626-448-7433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental