Provider Demographics
NPI:1336516285
Name:SHAWN LEE DMD LLC
Entity Type:Organization
Organization Name:SHAWN LEE DMD LLC
Other - Org Name:ALL ABOUT SMILES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-947-4086
Mailing Address - Street 1:237 E FIREWEED LN
Mailing Address - Street 2:#101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2000
Mailing Address - Country:US
Mailing Address - Phone:907-276-3804
Mailing Address - Fax:
Practice Address - Street 1:237 E FIREWEED LN
Practice Address - Street 2:#101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2000
Practice Address - Country:US
Practice Address - Phone:907-276-3804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1391261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental