| Kwang Lee D.d.s. Inc. | |
|
1558 W Grand Ave Grover Beach CA 93433-2236 | |
| (805) 489-8904 | |
| (805) 474-5899 |
| Full Name | Kwang Lee D.d.s. Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1558 W Grand Ave, Grover Beach, California |
| Authorized Official Name and Position | Kwang Lee (DENTIST) |
| Authorized Official Contact | 8054898904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwang Lee D.d.s. Inc. 1558 W Grand Ave Grover Beach CA 93433-2236 Ph: (805) 489-8904 | Kwang Lee D.d.s. Inc. 1558 W Grand Ave Grover Beach CA 93433-2236 Ph: (805) 489-8904 |
| NPI Number | 1154709442 |
|---|---|
| Provider Enumeration Date | 05/07/2015 |
| Last Update Date | 05/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154709442 | NPI | - | NPPES |
| 1223G0001X | Other | TAXANOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (California) | Primary |
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