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Organization
LY TUAN Q. D.D.S.,INC.
Active
Organization
LY TUAN Q. D.D.S.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAM THI DIEM LE D.D.S. (OWNER)
(714) 751-5538
Entity
Organization
Contact information
Practice address
3736 S BRISTOL ST, SANTA ANA, CA 92704-7304
(714) 751-5538
(714) 751-0431
Mailing address
3736 S BRISTOL ST, SANTA ANA, CA 92704-7304
(714) 751-5538
(714) 751-0431
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41948
CA
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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