Individual
JU YONG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4325 AIRLINE DR, BOSSIER CITY, LA 71111-2003
(318) 742-9333
(318) 747-9089
Mailing address
4335 S GRAND CANYON DR UNIT 442, LAS VEGAS, NV 89147-7194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
104283
CA
1223P0221X
Pediatric Dentistry
Primary
7748
LA
1223P0221X
Pediatric Dentistry
S6-238C
NV
Other
Enumeration date
08/09/2019
Last updated
01/09/2026
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