Provider Demographics
NPI:1184843336
Name:LEE, HUGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUGH
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 1:110 MELTON RD
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-9453
Mailing Address - Country:US
Mailing Address - Phone:541-895-4420
Mailing Address - Fax:541-895-4430
Practice Address - Street 1:110 MELTON RD
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:OR
Practice Address - Zip Code:97426-9453
Practice Address - Country:US
Practice Address - Phone:541-895-4420
Practice Address - Fax:541-895-4430
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD85041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice