Individual
DR. JUNGWOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11160 MEDLOCK BRIDGE RD, DULUTH, GA 30097-2641
(770) 847-7690
Mailing address
11210 OLBRICH TRL, JOHNS CREEK, GA 30097-2613
(480) 646-6107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12010693
IN
122300000X
Dentist
Primary
DN123077
GA
1223G0001X
General Practice Dentistry
D008679
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200501900
—
IN
Enumeration date
06/21/2006
Last updated
10/18/2023
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