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General NPI Number Information
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NPI Number | 1851523732
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Entity Type | Individual
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Provider Name | BRENT LEE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 7723 CLEARVIEW CHURCH LN
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City | LYLES
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State | TN
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Zip | 37098-1674
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Country | US
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Telephone | 931-670-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 7723 CLEARVIEW CHURCH LN
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City | LYLES
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State | TN
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Zip | 37098-1674
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Country | US
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Telephone | 931-670-5520
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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 | 9005
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License Number State | TN
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