| Chong Il Lee D.d.s A Professional Corporation | |
|
1739 S Euclid Ave Ste A Ontario CA 91762-5831 | |
| (909) 983-9325 | |
| (909) 467-9956 |
| Full Name | Chong Il Lee D.d.s A Professional Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1739 S Euclid Ave Ste A, Ontario, California |
| Authorized Official Name and Position | Chong Il Lee (PRESIDENT) |
| Authorized Official Contact | 9099839325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chong Il Lee D.d.s A Professional Corporation 1739 S Euclid Ave Ste A Ontario CA 91762-5831 Ph: (909) 983-9325 | Chong Il Lee D.d.s A Professional Corporation 1739 S Euclid Ave Ste A Ontario CA 91762-5831 Ph: (909) 983-9325 |
| NPI Number | 1164675195 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164675195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | B25931 (California) | Primary |
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