Organization
PHU THANH THIEN LE, DDS DENTAL CORP
Active
Other names
Little Gold Fish Children's Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHU T LE DDS (CEO)
(510) 517-5309
Entity
Organization
Contact information
Practice address
650 INTERNATIONAL BLVD STE A, OAKLAND, CA 94606-2987
(510) 517-5309
Mailing address
650 INTERNATIONAL BLVD STE A, OAKLAND, CA 94606-2987
(510) 517-5309
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2019
Last updated
07/27/2019
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