Individual
DR. ANDREW LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3811 N BROADWAY ST, CHICAGO, IL 60613-3217
(773) 281-7351
Mailing address
3811 N BROADWAY ST, CHICAGO, IL 60613-3217
(773) 281-7351
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004889
—
IL
Enumeration date
03/22/2007
Last updated
07/08/2007
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