Individual
DR. MELISSA KIM LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
345 N KENWOOD ST APT 206, GLENDALE, CA 91206-5406
(818) 653-7489
Mailing address
345 N KENWOOD ST APT 206, GLENDALE, CA 91206-5406
(818) 653-7489
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
25203
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
58042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25203
STATE BOARD OF DENTAL EXAMINERS
TX
01
—
58042
STATE LICENSE
CA
Enumeration date
02/05/2009
Last updated
02/17/2010
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