Organization Name: | LEE, WEE &BAEK. DDS. INC |
NPI Number: | 1699940486 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIN NAM BAEK (SECRETARY) |
Mailing Address: | 61325 29palms Hwy.ste.a Joshua Tree |
State: | CA US |
Postal Code: | 92252 |
Phone Number: | 7603660420 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2008 |
NPI Last Update Date: | 04/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 54709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |