Provider Demographics
NPI:1619350675
Name:SOO H. LEE D.D.S. AND ASSOCIATES
Entity Type:Organization
Organization Name:SOO H. LEE D.D.S. AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOO
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-310-9600
Mailing Address - Street 1:2357 HASSELL RD
Mailing Address - Street 2:STE 208
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2172
Mailing Address - Country:US
Mailing Address - Phone:847-310-9600
Mailing Address - Fax:847-310-9631
Practice Address - Street 1:2357 HASSELL RD
Practice Address - Street 2:STE 208
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2172
Practice Address - Country:US
Practice Address - Phone:847-310-9600
Practice Address - Fax:847-310-9631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190272461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty