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General NPI Number Information
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NPI Number | 1740062652
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Entity Type | Organization
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Legal Business Name | LEE CHUNG DDS PA
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 7431 NW LOOP 410 STE 105
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3597
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Country | US
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Telephone | 210-680-0553
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Fax | 210-680-0593
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Provider Business Mailing Address
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Address Line | 7431 NW LOOP 410 STE 105
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3597
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Country | US
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Telephone | 210-680-0553
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. LEE CHUNG
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Credential | DDS
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Telephone | 281-384-9183
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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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