Provider Demographics
NPI:1417052903
Name:LEE, DAVID BOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BOYD
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 1:400 LABORATORY RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6810
Mailing Address - Country:US
Mailing Address - Phone:865-483-1323
Mailing Address - Fax:865-482-4750
Practice Address - Street 1:400 LABORATORY RD
Practice Address - Street 2:SUITE 107
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6810
Practice Address - Country:US
Practice Address - Phone:865-483-1323
Practice Address - Fax:865-482-4750
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51341223G0001X
TNDS-00000051341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice