Provider Demographics
NPI:1447794607
Name:LEE & MILANI FAMILY DENTISTRY
Entity Type:Organization
Organization Name:LEE & MILANI FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAMHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-656-7600
Mailing Address - Street 1:12311 NACOGDOCHES RD
Mailing Address - Street 2:#107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-2138
Mailing Address - Country:US
Mailing Address - Phone:210-656-7600
Mailing Address - Fax:210-656-7660
Practice Address - Street 1:12311 NACOGDOCHES RD
Practice Address - Street 2:#107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-2138
Practice Address - Country:US
Practice Address - Phone:210-656-7600
Practice Address - Fax:210-656-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28970261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental