Provider Demographics
NPI:1295809044
Name:LE, PHU (DDS)
Entity type:Individual
Prefix:DR
First Name:PHU
Middle Name:
Last Name:LE
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:8227 OLD COURTHOUSE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3815
Mailing Address - Country:US
Mailing Address - Phone:703-288-4862
Mailing Address - Fax:703-288-4863
Practice Address - Street 1:8227 OLD COURTHOUSE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3815
Practice Address - Country:US
Practice Address - Phone:703-288-4862
Practice Address - Fax:703-288-4863
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-02-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD128261223X0400X
VA04014117001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics