Individual
JACQUELINE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
81-990 HALEKII ST #7, KEALAKEKUA, HI 96750
(907) 538-7051
Mailing address
81-990 HALEKII ST #7, KEALAKEKUA, HI 96750
(907) 538-7051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49135
CA
1223G0001X
General Practice Dentistry
2713
HI
Other
Enumeration date
05/21/2007
Last updated
07/21/2022
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