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Organization
LOTUS DENTAL PA
Active
Organization
LOTUS DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHOA T LE (D.D.S.)
(409) 466-7093
Entity
Organization
Contact information
Practice address
2106 N 11TH ST, BEAUMONT, TX 77703-4912
(409) 898-1748
Mailing address
2106 N 11TH ST, BEAUMONT, TX 77703-4912
(409) 898-1748
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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