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General NPI Number Information
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NPI Number | 1265980965
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Entity Type | Individual
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Provider Name | YOON HAENG LEE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 750 LAS GALLINAS AVE STE 108
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3431
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Country | US
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Telephone | 415-479-6444
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Fax |
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Provider Business Mailing Address
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Address Line | 1926 35TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-1110
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Country | US
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Telephone | 323-706-1783
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Fax |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 64155
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License Number State | CA
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