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General NPI Number Information
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NPI Number | 1104471333
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Entity Type | Organization
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Legal Business Name | HIGHWAY DENTAL INC
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 1055 ROHLWING ROAD
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007
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Country | US
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Telephone | 224-578-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 908 EDEN DRIVE
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City | SCHAUMBURG
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State | IL
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Zip | 60195
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Country | US
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Telephone | 224-578-1300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EUN-HEE LEE
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Credential | D.D.S.
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Telephone | 224-578-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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