Provider Demographics
NPI:1558625384
Name:LEE, DONG HYUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONG
Middle Name:HYUN
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 1:1060 S PRESTON RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-3895
Mailing Address - Country:US
Mailing Address - Phone:972-382-2900
Mailing Address - Fax:
Practice Address - Street 1:1060 S PRESTON RD STE 110
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-3895
Practice Address - Country:US
Practice Address - Phone:972-382-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28284122300000X
WI6919-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist