Individual
DR. THOMAS K LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
761 S MARINE CORPS DR, SUITE A2, TAMUNING, GU 96913-3523
(671) 969-8533
(671) 969-8534
Mailing address
761 S MARINE CORPS DR, SUITE A2, TAMUNING, GU 96913-3523
(671) 969-8533
(671) 969-8534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1020
GU
1223G0001X
General Practice Dentistry
44332
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L0015274
—
GU
Enumeration date
02/14/2007
Last updated
04/23/2017
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