Provider Demographics
NPI:1265515696
Name:LEE, TON VINH X (DDS)
Entity type:Individual
Prefix:
First Name:TON
Middle Name:VINH
Last Name:LEE
Suffix:X
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 1:4660 S EASTERN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6137
Mailing Address - Country:US
Mailing Address - Phone:702-456-7621
Mailing Address - Fax:702-456-7625
Practice Address - Street 1:4660 S EASTERN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6137
Practice Address - Country:US
Practice Address - Phone:702-456-7621
Practice Address - Fax:702-456-7625
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist