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Individual

DR. GRACE JI YEON PARK LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
1805 W 24TH ST, YUMA, AZ 85364-6104
(928) 726-7041
(928) 726-2638
Mailing address
1805 W 24TH ST, YUMA, AZ 85364-6104
(928) 726-7041
(928) 726-2638

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5582
AZ

Other

Enumeration date
11/01/2006
Last updated
07/08/2007
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