Individual
AMANDA PHUONG LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3453 BROOKSIDE RD STE A, STOCKTON, CA 95219-1788
(209) 955-1500
Mailing address
2018 BIARRITZ PL, SAN JOSE, CA 95138-2259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
110109
CA
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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