Provider Demographics
NPI:1043399330
Name:LEE, MCHENRY (DDS PC)
Entity Type:Individual
Prefix:DR
First Name:MCHENRY
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 1-2 N WELLS ST
Mailing Address - Street 2:
Mailing Address - City:EDNA
Mailing Address - State:TX
Mailing Address - Zip Code:77957
Mailing Address - Country:US
Mailing Address - Phone:361-782-7191
Mailing Address - Fax:361-782-5438
Practice Address - Street 1:118 N WELLS ST
Practice Address - Street 2:
Practice Address - City:EDNA
Practice Address - State:TX
Practice Address - Zip Code:77957
Practice Address - Country:US
Practice Address - Phone:361-782-7191
Practice Address - Fax:361-782-5438
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice