Organization
MINNESOTA LEE DENTAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HO YOUNG LEE D.D.S. (OWNER)
(763) 391-7522
Entity
Organization
Contact information
Practice address
6240 QUINWOOD LN N STE 102, MAPLE GROVE, MN 55369
(763) 391-7522
Mailing address
6240 QUINWOOD LN N STE 102, MAPLE GROVE, MN 55369-6384
(763) 391-7522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12317
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
760030000
—
MN
Enumeration date
06/26/2008
Last updated
09/14/2020
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