Provider Demographics
NPI:1881054443
Name:ROBERT JUN LEE DDS PLLC
Entity type:Organization
Organization Name:ROBERT JUN LEE DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-349-6286
Mailing Address - Street 1:18505 ALDERWOOD MALL PKWY
Mailing Address - Street 2:STE D
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-8012
Mailing Address - Country:US
Mailing Address - Phone:425-329-6677
Mailing Address - Fax:
Practice Address - Street 1:18505 ALDERWOOD MALL PKWY
Practice Address - Street 2:STE D
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8012
Practice Address - Country:US
Practice Address - Phone:425-329-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602211161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty