Provider Demographics
NPI:1497277487
Name:LEE, MAYLEEN LAURA (DDS)
Entity Type:Individual
Prefix:
First Name:MAYLEEN
Middle Name:LAURA
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25412 INTERSTATE 45 N
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1351
Mailing Address - Country:US
Mailing Address - Phone:281-363-0500
Mailing Address - Fax:281-363-0828
Practice Address - Street 1:25412 INTERSTATE 45 N
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1351
Practice Address - Country:US
Practice Address - Phone:281-363-0500
Practice Address - Fax:281-363-0828
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist