Provider Demographics
NPI:1417683889
Name:ERIK J. LEE D.D.S PLLC
Entity Type:Organization
Organization Name:ERIK J. LEE D.D.S PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-669-5595
Mailing Address - Street 1:898 44TH ST SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-9508
Mailing Address - Country:US
Mailing Address - Phone:616-669-5595
Mailing Address - Fax:888-453-2029
Practice Address - Street 1:898 44TH ST SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-9508
Practice Address - Country:US
Practice Address - Phone:616-669-5595
Practice Address - Fax:888-453-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty