Individual
MR. CHIA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
20071 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-8460
(253) 862-1015
Mailing address
20071 STATE ROUTE 410 E, BONNEY LAKE, WA 98391-5540
(253) 862-1015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
51611
CA
1223G0001X
General Practice Dentistry
Primary
DE 60200022
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D51611
MEDICAL DENTAL PROGRAM
CA
Enumeration date
01/22/2007
Last updated
11/03/2016
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