MEDICARE: DRS. DAVIS & LEE, DDS, PA

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
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1598007601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS. DAVIS & LEE, DDS, PA

Provider Business Mailing Address
First Line	:	2106 WERRINGTON DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3330
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2106 WERRINGTON DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-3330
Country	:	US
Telephone Number	:	919-762-7013
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	DR. BOO LEE
Credential	:
Telephone Number	:	919-762-7013

Provider Enumeration Date	:	03/27/2013
Last Update Date	:	03/27/2013

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