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General NPI Number Information
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NPI Number | 1609440379
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Entity Type | Organization
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Legal Business Name | SCOTT K LEE, DDS, PLLC
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 3100 S RURAL RD STE 2
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City | TEMPE
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State | AZ
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Zip | 85282-3868
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Country | US
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Telephone | 480-737-1787
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Fax |
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Provider Business Mailing Address
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Address Line | 2740 E CEDAR PL
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City | CHANDLER
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State | AZ
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Zip | 85249-3566
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Country | US
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Telephone | 480-789-3125
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT KYUNG-JIN LEE
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Credential | DDS
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Telephone | 480-737-1787
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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 |
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License Number State |
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