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Organization
STEVEN B LEE, DDS, PC
Active
Organization
STEVEN B LEE, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN B LEE DDS (PRESIDENT)
(260) 471-1222
Entity
Organization
Contact information
Practice address
1320 MEDICAL PARK DR, FORT WAYNE, IN 46825-5844
(260) 471-1222
(260) 471-1724
Mailing address
1320 MEDICAL PARK DR, FORT WAYNE, IN 46825-5844
(260) 471-1222
(260) 471-1724
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12008803
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000373783
BLUE CROSS BLUE SHIELD
IN
Enumeration date
04/11/2006
Last updated
04/15/2008
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