Individual
DR. TIMOTHY DAE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4021 RHEA RD, WICHITA FALLS, TX 76308-2727
(214) 923-0648
(940) 613-0213
Mailing address
4021 RHEA RD, WICHITA FALLS, TX 76308-2727
(214) 923-0648
(940) 613-0213
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22042
TX
1223P0221X
Pediatric Dentistry
80
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1701203-10
—
TX
05
—
200131900 A
—
OK
05
—
5441000
—
TN
Enumeration date
07/10/2006
Last updated
03/07/2016
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