Provider Demographics
NPI:1891925525
Name:LEE, STEPHANIE ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELIZABETH
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 1:650 COURT ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1799
Mailing Address - Country:US
Mailing Address - Phone:404-358-7177
Mailing Address - Fax:
Practice Address - Street 1:650 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1799
Practice Address - Country:US
Practice Address - Phone:404-358-7177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03728122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist