Individual
ELIZABETH LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
516 MARY ESTHER CTO NW STE 2, FORT WALTON BEACH, FL 32548-4025
(850) 659-3119
Mailing address
9612 PHIPPS LN, WELLINGTON, FL 33414-3404
(561) 713-3285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
26837
FL
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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