Individual
FRED MATTHEW LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
650 W BALTIMORE ST STE 6402, BALTIMORE, MD 21201-1510
(410) 706-7461
Mailing address
6709 MICHAELS DR, BETHESDA, MD 20817-2219
(301) 365-7005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401008317
VA
1223G0001X
General Practice Dentistry
Primary
8517
MD
1223G0001X
General Practice Dentistry
DEN4236
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016891200
—
DC
Enumeration date
05/02/2007
Last updated
05/05/2019
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