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NPI Code Detail

MEDICARE: DR. DAVID PETER LEE DMD

MEDICARE: DR. DAVID PETER LEE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN23902FL
21223X0400XOrthodontics and Dentofacial Orthopedics DentistryDS030279LPA
31223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN015621GA

General Provider Information

NPI Number : 1851388821
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID PETER LEE DMD
Provider Business Mailing Address
First Line : 1867 JONESBORO RD STE 12
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-6099
Country : US
Telephone Number : 770-222-2322
Fax Number :
Provider Business Practice Location Address
First Line : 1867 JONESBORO RD STE 12
Second Line :
City : MCDONOUGH
State : GA
Zip : 30253-6099
Country : US
Telephone Number : 770-222-2322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 08/11/2022

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Directions to “ DR. DAVID PETER LEE DMD” Practice Location

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