Provider Demographics
NPI:1952466849
Name:LE, TRA THANH (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRA
Middle Name:THANH
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:14591 NEWPORT AVE
Mailing Address - Street 2:SUITE # 108
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6001
Mailing Address - Country:US
Mailing Address - Phone:714-368-3334
Mailing Address - Fax:714-368-3335
Practice Address - Street 1:14591 NEWPORT AVE
Practice Address - Street 2:SUITE # 108
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6001
Practice Address - Country:US
Practice Address - Phone:714-368-3334
Practice Address - Fax:714-368-3335
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA435421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry