| Kwan Lee Dds Pllc | |
|
34616 11th Pl S Ste 4 Federal Way WA 98003-8705 | |
| (253) 941-2214 | |
| Not Available |
| Full Name | Kwan Lee Dds Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 34616 11th Pl S Ste 4, Federal Way, Washington |
| Authorized Official Name and Position | Kwan Moo Lee (PRESIDENT) |
| Authorized Official Contact | 2533478072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwan Lee Dds Pllc 34616 11th Pl S Ste 4 Federal Way WA 98003-8705 Ph: () - | Kwan Lee Dds Pllc 34616 11th Pl S Ste 4 Federal Way WA 98003-8705 Ph: (253) 941-2214 |
| NPI Number | 1902439912 |
|---|---|
| Provider Enumeration Date | 02/18/2020 |
| Last Update Date | 02/18/2020 |
| Medicare PECOS PAC ID | 9537590211 |
|---|---|
| Medicare Enrollment ID | O20200513000938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902439912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Kwan Moo Lee |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568496131 PECOS PAC ID: 1355347766 Enrollment ID: I20061006000624 |
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