Individual
DR. YONG WOONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6129 US HIGHWAY 6, PORTAGE, IN 46368-5058
(219) 600-8114
Mailing address
6129 US HIGHWAY 6, PORTAGE, IN 46368-5058
(219) 600-8114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401418154
VA
1223G0001X
General Practice Dentistry
Primary
12014278A
IN
Other
Enumeration date
12/21/2022
Last updated
12/08/2023
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