Individual
JADE LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
28321 S. TAMIAMI TRAIL, SUITE A1-2, BONITA SPRINGS, FL 34134
(239) 344-2322
(239) 390-0523
Mailing address
238 TAHITI RD, MARCO ISLAND, FL 34145
(239) 344-2322
(239) 390-0523
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN18068
FL
1223G0001X
General Practice Dentistry
Primary
3736
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418040000
—
ME
Enumeration date
04/26/2007
Last updated
10/06/2011
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