Organization
SOUTH INDEPENDENCE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LEE DDS (PARTNER)
(816) 897-5850
Entity
Organization
Contact information
Practice address
12400 E 40 HWY, INDEPENDENCE, MO 64055-5929
(816) 897-5850
(816) 897-5851
Mailing address
12400 E 40 HWY, INDEPENDENCE, MO 64055-5929
(816) 897-5850
(816) 897-5851
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
09/14/2020
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