Provider Demographics
NPI:1033483979
Name:LEE, SAT PYOL (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAT PYOL
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 BEAUMONT DR
Mailing Address - Street 2:#204
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1819
Mailing Address - Country:US
Mailing Address - Phone:859-537-1106
Mailing Address - Fax:
Practice Address - Street 1:1835 BROADWAY ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-2040
Practice Address - Country:US
Practice Address - Phone:708-345-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190289171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice