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General NPI Number Information
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NPI Number | 1174797013
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Entity Type | Individual
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Provider Name | DONG HOON LEE D.M.D
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Gender | Male
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 109 JOLLY ST
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City | LOUISBURG
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State | NC
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Zip | 27549-2239
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Country | US
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Telephone | 919-496-5734
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Fax | 919-496-2599
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Provider Business Mailing Address
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Address Line | 109 JOLLY ST
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City | LOUISBURG
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State | NC
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Zip | 27549-2239
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Country | US
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Telephone | 919-496-5734
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Fax | 919-496-2599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS037174
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9417
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License Number State | NC
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