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General NPI Number Information
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NPI Number | 1316657109
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Entity Type | Organization
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Legal Business Name | JOSEPH KIM DANIEL LEE & JOHN HODGES DDS PLLC
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 3215 SE 192ND AVE STE 112
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City | VANCOUVER
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State | WA
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Zip | 98683-1469
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Country | US
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Telephone | 253-833-9914
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Fax | 253-833-9914
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Provider Business Mailing Address
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Address Line | 3215 SE 192ND AVE STE 112
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City | VANCOUVER
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State | WA
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Zip | 98683-1469
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Country | US
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Telephone | 253-833-9914
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Fax | 253-833-9914
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. TAMI ODEN
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Credential |
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Telephone | 206-992-6817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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