Provider Demographics
NPI:1659734655
Name:LEE, CHRISTOPHER M (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:LEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:POSTLE HALL 4015
Mailing Address - Street 2:305 W 12TH AVE.
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-0001
Mailing Address - Country:US
Mailing Address - Phone:614-292-1472
Mailing Address - Fax:
Practice Address - Street 1:POSTLE HALL 4015
Practice Address - Street 2:305 W 12TH AVE
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-292-1472
Practice Address - Fax:614-688-3553
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0256201223G0001X
KY98131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice