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General NPI Number Information
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NPI Number | 1851388821
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Entity Type | Individual
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Provider Name | DAVID PETER LEE DMD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 1867 JONESBORO RD STE 12
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City | MCDONOUGH
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State | GA
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Zip | 30253-6099
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Country | US
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Telephone | 770-222-2322
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Fax |
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Provider Business Mailing Address
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Address Line | 1867 JONESBORO RD STE 12
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City | MCDONOUGH
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State | GA
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Zip | 30253-6099
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Country | US
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Telephone | 770-222-2322
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN23902
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS030279L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN015621
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License Number State | GA
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