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Organization
MINNESOTA LEE DENTAL CLINIC, P.C.
Active
Organization
MINNESOTA LEE DENTAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HO YOUNG LEE D.D.S. (OWNER)
(763) 391-7522
Entity
Organization
Contact information
Practice address
6240 QUINWOOD LN N STE 102, MAPLE GROVE, MN 55369
(763) 391-7522
Mailing address
6240 QUINWOOD LN N STE 102, MAPLE GROVE, MN 55369-6384
(763) 391-7522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12317
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
760030000
—
MN
Enumeration date
06/26/2008
Last updated
09/14/2020
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