Provider Demographics
NPI:1427072545
Name:LE, CHUCK T (DDS)
Entity type:Individual
Prefix:
First Name:CHUCK
Middle Name:T
Last Name:LE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:TRUC
Other - Middle Name:T
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2265 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-6503
Mailing Address - Country:US
Mailing Address - Phone:714-491-8600
Mailing Address - Fax:714-491-8666
Practice Address - Street 1:2265 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6503
Practice Address - Country:US
Practice Address - Phone:714-491-8600
Practice Address - Fax:714-491-8666
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice