Individual
THAO LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2175 TULLY RD, SAN JOSE, CA 95122-1346
(408) 272-7171
Mailing address
2175 TULLY RD, SAN JOSE, CA 95122-1346
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
43710
CA
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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