Provider Demographics
NPI:1093981805
Name:LEE, W.S. MAGGIE (DDS)
Entity Type:Individual
Prefix:
First Name:W.S. MAGGIE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300B SPRINGFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-3431
Mailing Address - Country:US
Mailing Address - Phone:703-569-8991
Mailing Address - Fax:703-569-9045
Practice Address - Street 1:6300B SPRINGFIELD PLZ
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3431
Practice Address - Country:US
Practice Address - Phone:703-569-8991
Practice Address - Fax:703-569-9045
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice