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General NPI Number Information
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NPI Number | 1528352861
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Entity Type | Individual
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Provider Name | ANNA EUN LEE D.D.S
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Gender | Female
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 07/06/2012
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Provider Practice Location Address
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Address Line | 5057 KELLER SPRINGS RD
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City | ADDISON
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State | TX
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Zip | 75001-6231
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Country | US
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Telephone | 214-522-2008
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Fax |
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Provider Business Mailing Address
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Address Line | 102 BARDWELL DR
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City | ALLEN
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State | TX
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Zip | 75002-3912
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Country | US
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Telephone | 469-855-2283
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 26530
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License Number State | TX
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