Individual
CAROL LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E HURON ST, GALTER PAVILION SUITE 2-246, CHICAGO, IL 60611-3197
(312) 926-3264
Mailing address
25 W 15TH ST, UNIT A, CHICAGO, IL 60605-2796
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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