Individual
DR. VIVIAN T LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
378 JONESBORO RD, MCDONOUGH, GA 30253-3797
(770) 898-9191
(770) 898-3598
Mailing address
378 JONESBORO RD, MCDONOUGH, GA 30253-3797
(770) 898-9191
(770) 898-3598
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012167
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1368182
UNITED CONCORDIA
GA
Enumeration date
05/31/2006
Last updated
07/09/2007
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