# DR SUNG Y LEE DMD A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962074997
- **Authorized official:** DR. SUNG YOUNG LEE DMD (PRESIDENT)
- **Authorized official phone:** (951) 736-0641

## Contact information

- **Practice address:** 828 W 6TH ST, CORONA, CA 92882-3237
- **Practice address phone:** (951) 736-0641
- **Mailing address:** 828 W 6TH ST, CORONA, CA 92882-3237
- **Mailing address phone:** (951) 736-0641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 07/09/2021
- **Last updated:** 07/27/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1972643856 | — | CA |