Provider Demographics
NPI:1932384146
Name:LEE KOH, NAOMI WON (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:WON
Last Name:LEE KOH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 FRAZIER AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4116
Mailing Address - Country:US
Mailing Address - Phone:423-634-2333
Mailing Address - Fax:423-634-2332
Practice Address - Street 1:417 FRAZIER AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4116
Practice Address - Country:US
Practice Address - Phone:423-634-2333
Practice Address - Fax:423-634-2332
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice