Organization
OMALEE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E LEE D.M.D. (OWNER)
(229) 838-4203
Entity
Organization
Contact information
Practice address
14 SIXTH AVE, OMAHA, GA 31821
(229) 838-4203
(229) 838-4204
Mailing address
14 SIXTH AVE BOX 200, OMAHA, GA 31821
(229) 838-4203
(229) 838-4204
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN010226
GA
Other
Enumeration date
06/17/2009
Last updated
06/17/2009
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