Individual
LIEN LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
909 DAVIS ST, SUITE 120, EVANSTON, IL 60201-3789
(847) 475-6300
(847) 475-6560
Mailing address
909 DAVIS ST, SUITE 120, EVANSTON, IL 60201-3683
(847) 475-6300
(847) 475-6560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-026357
IL
Other
Enumeration date
03/29/2007
Last updated
03/17/2011
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