Provider Demographics
NPI:1134218217
Name:LEE, SEUNG HUN
Entity type:Individual
Prefix:
First Name:SEUNG
Middle Name:HUN
Last Name:LEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 S PEORIA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3413
Mailing Address - Country:US
Mailing Address - Phone:303-341-4878
Mailing Address - Fax:720-858-9080
Practice Address - Street 1:1075 SOUTH PEORIA STREET
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3263
Practice Address - Country:US
Practice Address - Phone:303-341-4878
Practice Address - Fax:720-858-9080
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74781223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics