Provider Demographics
NPI:1740023597
Name:BYUNG WOOK LEE D.D.S. INC
Entity type:Organization
Organization Name:BYUNG WOOK LEE D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JEONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-766-0662
Mailing Address - Street 1:555 S WESTERN AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4270
Mailing Address - Country:US
Mailing Address - Phone:323-766-0662
Mailing Address - Fax:
Practice Address - Street 1:555 S WESTERN AVE STE 208
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-4270
Practice Address - Country:US
Practice Address - Phone:323-766-0662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty