| Minnesota Lee Dental Clinic, P.c. | |
|
6240 Quinwood Ln N Ste 102 Maple Grove MN 55369 | |
| (763) 391-7522 | |
| Not Available |
| Full Name | Minnesota Lee Dental Clinic, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6240 Quinwood Ln N Ste 102, Maple Grove, Minnesota |
| Authorized Official Name and Position | Ho Young Lee (OWNER) |
| Authorized Official Contact | 7633917522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Lee Dental Clinic, P.c. 6240 Quinwood Ln N Ste 102 Maple Grove MN 55369-6384 Ph: (763) 391-7522 | Minnesota Lee Dental Clinic, P.c. 6240 Quinwood Ln N Ste 102 Maple Grove MN 55369 Ph: (763) 391-7522 |
| NPI Number | 1932361474 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 09/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932361474 | NPI | - | NPPES |
| 760030000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12317 (Minnesota) | Primary |
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