Provider Demographics
NPI:1467029264
Name:LEE, RAYMOND BOK (DDS)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:BOK
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 1:2250 S RANCHO DR STE 205
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4456
Mailing Address - Country:US
Mailing Address - Phone:702-291-2031
Mailing Address - Fax:702-984-7566
Practice Address - Street 1:4720 BLUE DIAMOND RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7609
Practice Address - Country:US
Practice Address - Phone:702-291-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program