Provider Demographics
NPI:1720362767
Name:LEE, HAN B (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAN
Middle Name:B
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 LEESVILLE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7540
Mailing Address - Country:US
Mailing Address - Phone:919-844-8826
Mailing Address - Fax:
Practice Address - Street 1:9201 LEESVILLE RD STE 160
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7540
Practice Address - Country:US
Practice Address - Phone:919-844-8826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0386891223X0400X
NC111471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics