Provider Demographics
NPI:1790374791
Name:WOO YONG LEE DDS INC
Entity Type:Organization
Organization Name:WOO YONG LEE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WOO
Authorized Official - Middle Name:YONG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-663-4214
Mailing Address - Street 1:1509 BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4901
Mailing Address - Country:US
Mailing Address - Phone:909-663-4214
Mailing Address - Fax:
Practice Address - Street 1:1728 N D ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4418
Practice Address - Country:US
Practice Address - Phone:909-886-0087
Practice Address - Fax:909-886-3533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental