Individual
DR. KEVIN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
131 PARK HILL DR STE A, FREDERICKSBURG, VA 22401-3357
(540) 373-0602
Mailing address
34 BELLS RIDGE DR, STAFFORD, VA 22554-8423
(540) 373-0602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008756
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008756
DELTA OF VIRGINIA
VA
01
—
191780
ANTHEM BCBS
VA
01
—
613532
UNITED CONCORDIA
VA
Enumeration date
04/17/2007
Last updated
07/08/2007
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