Provider Demographics
NPI:1790956951
Name:STEVEN S LEE, D.D.S. INC
Entity Type:Organization
Organization Name:STEVEN S LEE, D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-928-4596
Mailing Address - Street 1:820 W. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025-0280
Mailing Address - Country:US
Mailing Address - Phone:740-928-4596
Mailing Address - Fax:740-928-0761
Practice Address - Street 1:820 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:OH
Practice Address - Zip Code:43025-0280
Practice Address - Country:US
Practice Address - Phone:740-928-4596
Practice Address - Fax:740-928-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2576734Medicaid