Provider Demographics
NPI:1700919370
Name:LINDA TU LE DDS INC
Entity type:Organization
Organization Name:LINDA TU LE DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHACH
Authorized Official - Middle Name:N
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-574-9600
Mailing Address - Street 1:2160 W GRANT LINE RD STE 245
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7335
Mailing Address - Country:US
Mailing Address - Phone:209-834-0572
Mailing Address - Fax:209-834-0582
Practice Address - Street 1:2160 W GRANT LINE RD STE 245
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-7335
Practice Address - Country:US
Practice Address - Phone:209-834-0572
Practice Address - Fax:209-834-0582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty