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General NPI Number Information
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NPI Number | 1922507607
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Entity Type | Organization
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Legal Business Name | VANCOUVER JOHN J LEE DDS,PC
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 7819 NE 13TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98665-9601
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Country | US
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Telephone | 360-546-1106
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Fax | 360-546-0782
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Provider Business Mailing Address
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Address Line | 7819 NE 13TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98665-9601
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Country | US
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Telephone | 360-546-1106
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Fax |
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Authorized Official
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Title or Position | DENTIST/ OWNER
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Name | DR. JOHN J LEE
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Credential | DDS
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Telephone | 360-546-1106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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