Provider Demographics
NPI:1427771039
Name:LEI FU DDS LLC
Entity type:Organization
Organization Name:LEI FU DDS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LEI
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-800-1196
Mailing Address - Street 1:1136 WALES DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5700
Mailing Address - Country:US
Mailing Address - Phone:504-284-8829
Mailing Address - Fax:866-520-9010
Practice Address - Street 1:3855 GLADE RD STE 150
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-4814
Practice Address - Country:US
Practice Address - Phone:406-800-1196
Practice Address - Fax:866-520-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty