Provider Demographics
NPI:1942387600
Name:LEE, STEVEN S (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:S
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 1:11 S MILL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3680
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
Practice Address - Country:US
Practice Address - Phone:740-928-4596
Practice Address - Fax:740-928-0761
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2311439Medicaid