Provider Demographics
NPI:1902017528
Name:LEE, KEE HYUK (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEE
Middle Name:HYUK
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14430 ROOSEVELT AVE
Mailing Address - Street 2:SUITE L3
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6256
Mailing Address - Country:US
Mailing Address - Phone:718-353-4091
Mailing Address - Fax:
Practice Address - Street 1:14430 ROOSEVELT AVE
Practice Address - Street 2:SUITE L3
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6256
Practice Address - Country:US
Practice Address - Phone:718-353-4091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0437581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice