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Individual

LINDA LE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5135 SKYLINE RD S, SALEM, OR 97306-9427
(503) 588-6560
Mailing address
5135 SKYLINE RD S, SALEM, OR 97306-9427

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8113
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1223G0001X
GENERAL PRACTICE
OR
Enumeration date
08/09/2006
Last updated
07/08/2007
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