Provider Demographics
NPI:1649754672
Name:DONGMIN LEE, DDS, PLLC
Entity Type:Organization
Organization Name:DONGMIN LEE, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONGMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-599-6667
Mailing Address - Street 1:8351 STANDONSHIRE WAY STE 121
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2760
Mailing Address - Country:US
Mailing Address - Phone:919-599-6667
Mailing Address - Fax:
Practice Address - Street 1:8351 STANDONSHIRE WAY STE 121
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2760
Practice Address - Country:US
Practice Address - Phone:919-599-6667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental