Provider Demographics
NPI:1912360256
Name:DANIEL LEE DDS PLLC
Entity Type:Organization
Organization Name:DANIEL LEE DDS PLLC
Other - Org Name:COVINGTON SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-630-2483
Mailing Address - Street 1:27015 169TH PL SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5574
Mailing Address - Country:US
Mailing Address - Phone:253-630-2483
Mailing Address - Fax:
Practice Address - Street 1:27015 169TH PL SE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042
Practice Address - Country:US
Practice Address - Phone:253-630-2483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty