Individual
DR. CHANG SOO LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2387 US HIGHWAY 86, IMPERIAL, CA 92251-9780
(760) 353-0576
(760) 353-0576
Mailing address
2387 US HIGHWAY 86, IMPERIAL, CA 92251-9780
(760) 353-5100
(760) 353-0576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
45132
CA
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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