Provider Demographics
NPI:1427730811
Name:LE'CENTRE DENTISTRY P.L.L.C.
Entity type:Organization
Organization Name:LE'CENTRE DENTISTRY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THAO
Authorized Official - Middle Name:PHUOC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-661-7520
Mailing Address - Street 1:7317 OAKLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4144
Mailing Address - Country:US
Mailing Address - Phone:920-661-7520
Mailing Address - Fax:
Practice Address - Street 1:312 CENTRAL AVE SE STE 440
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-1052
Practice Address - Country:US
Practice Address - Phone:612-379-2428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental