Individual
HOANH BA LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
430 N WOODLAWN ST, WICHITA, KS 67208-4300
(316) 684-2100
(316) 684-2101
Mailing address
430 N WOODLAWN ST, WICHITA, KS 67208-4300
(316) 684-2100
(316) 684-2101
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6522
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116771
BLUE CROSS BLUE SHIELD
KS
Enumeration date
04/20/2006
Last updated
04/16/2018
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