Provider Demographics
NPI:1659579068
Name:LEE, LOIS AGATHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:AGATHA
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 1:6206 168TH ST SW
Mailing Address - Street 2:SUITE C
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-2749
Mailing Address - Country:US
Mailing Address - Phone:425-742-9609
Mailing Address - Fax:
Practice Address - Street 1:6206 168TH ST SW
Practice Address - Street 2:SUITE C
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-2749
Practice Address - Country:US
Practice Address - Phone:425-742-9609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60080602122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist