Individual
DAVID FORMOSAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30 E 40TH ST RM 305, NEW YORK, NY 10016-1247
(212) 370-1919
Mailing address
4436 TIMBERLAKE DRIVE, LOUISVILLE, TN 37777
(865) 970-2821
(865) 983-0870
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
50 053083
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02907899
—
NY
Enumeration date
04/13/2007
Last updated
06/08/2020
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