Individual
MISOOK NICOLE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
7500 N MESA, SUITE 304, EL PASO, TX 79912-3512
(915) 231-9983
(915) 231-9966
Mailing address
7500 N MESA, SUITE 304, EL PASO, TX 79912-3512
(915) 231-9983
(915) 231-9966
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22657
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740333442
—
TX
05
—
9185811
—
NM
Enumeration date
01/18/2007
Last updated
07/09/2007
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