Individual
JOHNNY LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
20011 BALLINGER WAY NE STE B-100, SHORELINE, WA 98155-1286
(206) 946-6471
Mailing address
12305 9TH AVE SW, SEATTLE, WA 98146-2704
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61166979
WA
Other
Enumeration date
05/13/2021
Last updated
08/02/2021
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