Provider Demographics
NPI:1518188804
Name:LEE, WINSTON WHANG (DDS)
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:WHANG
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 1:7840 HICKORY FLAT HWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2099
Mailing Address - Country:US
Mailing Address - Phone:770-479-8654
Mailing Address - Fax:770-479-8654
Practice Address - Street 1:7840 HICKORY FLAT HWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-2099
Practice Address - Country:US
Practice Address - Phone:770-479-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN011778122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist