Individual
JINHWA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4919 OUTER LOOP, LOUISVILLE, KY 40219-4051
(502) 861-5257
Mailing address
1216 BLACKTHORN RD, LOUISVILLE, KY 40299-4687
(931) 444-0404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11150
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2024
Last updated
05/29/2024
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