| Johnny Le Pllc | |
|
27202 Maple Valley-black Diamond Rd Se Ste 104 Maple Valley WA 98003 | |
| (425) 341-1671 | |
| (253) 461-5493 |
| Full Name | Johnny Le Pllc |
|---|---|
| Speciality | Dentist |
| Location | 27202 Maple Valley-black Diamond Rd Se, Maple Valley, Washington |
| Authorized Official Name and Position | Carol Canava (VP REVENUE CYCLE) |
| Authorized Official Contact | 9723610600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnny Le Pllc 27202 Maple Valley-black Diamond Rd Se Ste 104 Maple Valley WA 98003 Ph: (425) 341-1671 | Johnny Le Pllc 27202 Maple Valley-black Diamond Rd Se Ste 104 Maple Valley WA 98003 Ph: (425) 341-1671 |
| NPI Number | 1942176201 |
|---|---|
| Provider Enumeration Date | 10/14/2025 |
| Last Update Date | 10/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942176201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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Peter W Jacobsen Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 27016 Maple Valley Blk Diamond Rd Se, Maple Valley, WA 98038 Phone: 425-413-8525 Fax: 425-413-8599 | |
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