| Dr Sung Y Lee Dmd A Professional Corporation | |
|
828 W 6th St Corona CA 92882-3237 | |
| (951) 736-0641 | |
| Not Available |
| Full Name | Dr Sung Y Lee Dmd A Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 828 W 6th St, Corona, California |
| Authorized Official Name and Position | Sung Young Lee (PRESIDENT) |
| Authorized Official Contact | 9517360641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Sung Y Lee Dmd A Professional Corporation 828 W 6th St Corona CA 92882-3237 Ph: (951) 736-0641 | Dr Sung Y Lee Dmd A Professional Corporation 828 W 6th St Corona CA 92882-3237 Ph: (951) 736-0641 |
| NPI Number | 1962074997 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 07/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962074997 | NPI | - | NPPES |
| 1972643856 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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