Provider Demographics
NPI:1073010427
Name:LEE, ERIC H (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HONG SEOK LEE DDS
Mailing Address - Street 1:915 N QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1907
Mailing Address - Country:US
Mailing Address - Phone:703-276-1010
Mailing Address - Fax:
Practice Address - Street 1:6217 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1605
Practice Address - Country:US
Practice Address - Phone:405-896-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental