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Individual

DR. SALLY AI THIEN LE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
6416 S ELM PL, BROKEN ARROW, OK 74011-4819
(918) 940-3244
Mailing address
3704 S MIMOSA AVE, BROKEN ARROW, OK 74011-1143
(918) 853-1128

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6795
OK

Other

Enumeration date
08/29/2016
Last updated
08/29/2016
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