Individual
WON JONG LEE
Active
Individual
WON JONG LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
101135
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
101135
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S2-203C
NV
Other
Enumeration date
07/10/2017
Last updated
05/31/2023
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