Individual
GABRIELLE LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2191 DEFENSE HWY STE 210, CROFTON, MD 21114-2942
(410) 721-2610
Mailing address
2191 DEFENSE HWY STE 210, CROFTON, MD 21114-2942
(410) 721-2610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16832
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2019
Last updated
11/17/2020
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