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NPI Code Detail

MEDICARE: LOVELEE DENTAL, LLC

MEDICARE: LOVELEE DENTAL, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1285405993
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOVELEE DENTAL, LLC
Provider Business Mailing Address
First Line : 7380 SPOUT SPRINGS RD STE 120
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-7535
Country : US
Telephone Number : 770-965-5548
Fax Number :
Provider Business Practice Location Address
First Line : 7380 SPOUT SPRINGS RD STE 120
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-7535
Country : US
Telephone Number : 770-965-5548
Fax Number :
Authorized Official
Title or Position : OWNER/ DENTIST
Name : JEMIN LEE
Credential : DMD
Telephone Number : 770-965-5548
Provider Enumeration Date : 01/11/2024
Last Update Date : 01/16/2024

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Directions to “LOVELEE DENTAL, LLC ” Practice Location

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