Individual
DR. JESSE G LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 N ELLIS AVE, DUNN, NC 28334-3807
(910) 892-2137
(910) 892-2546
Mailing address
210 N ELLIS AVE, DUNN, NC 28334-3807
(910) 892-2137
(910) 892-2546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3472
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8995206
—
NC
01
—
95206
BCBS
NC
Enumeration date
06/29/2006
Last updated
07/08/2007
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