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General NPI Number Information
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NPI Number | 1437598067
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Entity Type | Individual
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Provider Name | DONGMIN LEE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 09/15/2018
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Provider Practice Location Address
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Address Line | 12330 NC-210 115
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City | BENSON
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State | NC
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Zip | 27504
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Country | US
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Telephone | 919-599-6667
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Fax |
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Provider Business Mailing Address
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Address Line | 106 PARKMAN GRANT DR
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City | CARY
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State | NC
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Zip | 27519-1847
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Country | US
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Telephone | 919-599-6667
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9553
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License Number State | NC
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