Provider Demographics
NPI:1659630259
Name:HYUN Y LEE DDS INC
Entity Type:Organization
Organization Name:HYUN Y LEE DDS INC
Other - Org Name:SELMA FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:YONG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-896-5011
Mailing Address - Street 1:3410 MCCALL AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662
Mailing Address - Country:US
Mailing Address - Phone:559-896-5011
Mailing Address - Fax:559-896-5410
Practice Address - Street 1:3410 MCCALL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662
Practice Address - Country:US
Practice Address - Phone:559-896-5011
Practice Address - Fax:559-896-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty