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Organization

STEVEN B LEE, DDS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN B LEE DDS (PRESIDENT)
(260) 471-1222
Entity
Organization

Contact information

Practice address
1320 MEDICAL PARK DR, FORT WAYNE, IN 46825-5844
(260) 471-1222
(260) 471-1724
Mailing address
1320 MEDICAL PARK DR, FORT WAYNE, IN 46825-5844
(260) 471-1222
(260) 471-1724

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12008803
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000373783
BLUE CROSS BLUE SHIELD
IN
Enumeration date
04/11/2006
Last updated
04/15/2008
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