Individual
PROF. NGHIEM THANH LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8885
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
52417
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55071384
—
NM
05
—
871708
—
AZ
Enumeration date
11/03/2006
Last updated
02/06/2023
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