Provider Demographics
NPI:1811319205
Name:SHAUN S. LEE D.D.S
Entity type:Organization
Organization Name:SHAUN S. LEE D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-939-3440
Mailing Address - Street 1:1320 8TH ST NE STE 103
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4589
Mailing Address - Country:US
Mailing Address - Phone:253-939-3440
Mailing Address - Fax:253-939-2818
Practice Address - Street 1:1320 8TH ST NE STE 103
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4589
Practice Address - Country:US
Practice Address - Phone:253-939-3440
Practice Address - Fax:253-939-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE600864751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty