Individual
MISS THUTAM THI LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2802 RYAN ST STE 26, LAKE CHARLES, LA 70601-7393
(318) 219-5167
Mailing address
755 SHERWOOD FOREST BLVD, BATON ROUGE, LA 70815-5261
(225) 505-6652
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6049
LA
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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