Individual
MS. EDWINA FAYE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
EXIT 102 OFF I40, 1/2 MI SOUTH, SAN FIDEL, NM 87049
(505) 552-5310
(505) 552-5490
Mailing address
PO BOX 130, ACOMA CANONCITO LAGUNA INDIAN HOSPITAL DHHS IHS, SAN FIDEL, NM 87049-0130
(505) 552-5385
(505) 552-5473
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2038
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
05/09/2007
Last updated
07/08/2007
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