Organization
TIMOTHY D. LEE, DDS, PC
Active
Other names
Children's Dentistry of Wichita Falls
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY DAE LEE D.D.S. (PRESIDENT)
(214) 923-0648
Entity
Organization
Contact information
Practice address
4021 RHEA RD, WICHITA FALLS, TX 76308-2727
(940) 613-0210
(940) 613-0213
Mailing address
4021 RHEA RD, WICHITA FALLS, TX 76308-2727
(940) 613-0210
(940) 613-0213
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22042
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209326201
—
TX
05
—
3469330-01
—
TX
Enumeration date
03/04/2010
Last updated
03/07/2016
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