Individual
JAE WOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 PROFESSIONAL CT SE, CALHOUN, GA 30701-7036
(917) 745-2019
Mailing address
105 PROFESSIONAL CT SE, CALHOUN, GA 30701-7036
(917) 745-2019
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123111
GA
Other
Enumeration date
06/15/2022
Last updated
03/17/2026
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