Individual
DONALD DONG-CHEON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
228 HARRISON AVE, CENTRALIA, WA 98531-1324
(909) 528-4292
Mailing address
228 HARRISON AVE, CENTRALIA, WA 98531-1324
(909) 528-4292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
25997
TX
122300000X
Dentist
Primary
DE 60189640
WA
1223G0001X
General Practice Dentistry
60189640
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25997
DENTAL LICENSE NUMBER
TX
Enumeration date
08/10/2010
Last updated
12/14/2020
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