Provider Demographics
NPI:1881286987
Name:SEUNG H LEE DENTAL GROUP INC
Entity type:Organization
Organization Name:SEUNG H LEE DENTAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SEUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-341-4878
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:
Practice Address - Street 1:7398 FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4904
Practice Address - Country:US
Practice Address - Phone:303-847-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEUNG H LEE DENTAL GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-09
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty