Provider Demographics
NPI:1013235704
Name:HUONG LE, DMD, PC
Entity Type:Organization
Organization Name:HUONG LE, DMD, PC
Other - Org Name:LE ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:T
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-734-5859
Mailing Address - Street 1:218 N BROADWAY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-3947
Mailing Address - Country:US
Mailing Address - Phone:360-533-1660
Mailing Address - Fax:360-533-2556
Practice Address - Street 1:218 N BROADWAY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-3947
Practice Address - Country:US
Practice Address - Phone:360-533-1660
Practice Address - Fax:360-533-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 000099061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty