Provider Demographics
NPI:1124179742
Name:LEE, JOSHUA (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 OLD PEACHTREE RD NW STE 312
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3324
Mailing Address - Country:US
Mailing Address - Phone:770-368-9700
Mailing Address - Fax:770-696-2974
Practice Address - Street 1:1032 OLD PEACHTREE RD NW STE 312
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-3324
Practice Address - Country:US
Practice Address - Phone:770-368-9700
Practice Address - Fax:770-696-2974
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0133601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice