Provider Demographics
NPI:1477007938
Name:SHELLY L. LEE, DDS, MS, INC
Entity Type:Organization
Organization Name:SHELLY L. LEE, DDS, MS, INC
Other - Org Name:LEE AND MURRIN ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:614-459-2000
Mailing Address - Street 1:1570 FISHINGER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2114
Mailing Address - Country:US
Mailing Address - Phone:614-459-2000
Mailing Address - Fax:614-459-5733
Practice Address - Street 1:1570 FISHINGER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2114
Practice Address - Country:US
Practice Address - Phone:614-459-2000
Practice Address - Fax:614-459-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH211251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty