Healthcare Provider Details

I. General information

NPI: 1417052903
Provider Name (Legal Business Name): DAVID BOYD LEE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BUS TERMINAL RD
OAK RIDGE TN
37830-6903
US

IV. Provider business mailing address

201 BUS TERMINAL RD
OAK RIDGE TN
37830-6903
US

V. Phone/Fax

Practice location:
  • Phone: 865-483-1323
  • Fax: 865-482-4750
Mailing address:
  • Phone: 865-483-1323
  • Fax: 865-482-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5134
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: