Healthcare Provider Details
I. General information
NPI: 1790956951
Provider Name (Legal Business Name): STEVEN S LEE, D.D.S. INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2008
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
820 W. MAIN ST.
HEBRON OH
43025-0280
US
IV. Provider business mailing address
820 W. MAIN ST.
HEBRON OH
43025-0280
US
V. Phone/Fax
- Phone: 740-928-4596
- Fax: 740-928-0761
- Phone: 740-928-4596
- Fax: 740-928-0761
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name: DR.
STEVEN
S
LEE
Title or Position: PRESIDENT/OWNER
Credential: D.D.S.
Phone: 740-928-4596