Individual
DR. WONSEOK LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4444 W NORTHERN AVE, SUITE A3, GLENDALE, AZ 85301
(623) 842-1075
(623) 931-5881
Mailing address
4444 W NORTHERN AVE, SUITE A3, GLENDALE, AZ 85301
(623) 842-1075
(623) 931-5881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4338
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135229
AHCCCS
AZ
01
—
197388
UNITED CONCORDIA
—
01
—
533689
AETNA DENTAL
—
01
—
AZ0489860
BCBS DENTAL
—
Enumeration date
03/13/2007
Last updated
07/08/2007
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