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NPI Code Detail

MEDICARE: S.K.LEE, DDS, PC.

MEDICARE: S.K.LEE, DDS, PC.
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1902408305
Entity Type Code : Organization
Provider Name (Legal Business Name) : S.K.LEE, DDS, PC.
Provider Business Mailing Address
First Line : 1391 S DIAMOND BAR BLVD
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-2208
Country : US
Telephone Number : 909-860-1222
Fax Number :
Provider Business Practice Location Address
First Line : 1391 S DIAMOND BAR BLVD
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-2208
Country : US
Telephone Number : 909-860-1222
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. SOONKI LEE
Credential : DDS
Telephone Number : 617-893-4423
Provider Enumeration Date : 11/10/2020
Last Update Date : 11/10/2020

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