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General NPI Number Information
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NPI Number | 1346060480
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Entity Type | Organization
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Legal Business Name | MIN LEE DDS
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 6383 ATLANTIC AVE
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City | BELL
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State | CA
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Zip | 90201-1227
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Country | US
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Telephone | 310-363-5107
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Fax |
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Provider Business Mailing Address
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Address Line | 801 S GRAND AVE APT 1306
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City | LOS ANGELES
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State | CA
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Zip | 90017-4672
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MIN LEE
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Credential |
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Telephone | 310-363-5107
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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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