| Sang Eun Lee D.d.s. Inc. | |
|
620 Alabama St Redlands CA 92373-8059 | |
| (909) 851-7323 | |
| Not Available |
| Full Name | Sang Eun Lee D.d.s. Inc. |
|---|---|
| Speciality | Dentist |
| Location | 620 Alabama St, Redlands, California |
| Authorized Official Name and Position | Sang Eun Lee (C.E.O.) |
| Authorized Official Contact | 9098517323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sang Eun Lee D.d.s. Inc. 620 Alabama St Redlands CA 92373-8059 Ph: (909) 851-7323 | Sang Eun Lee D.d.s. Inc. 620 Alabama St Redlands CA 92373-8059 Ph: (909) 851-7323 |
| NPI Number | 1083890917 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 11/16/2016 |
| Medicare PECOS PAC ID | 6002294865 |
|---|---|
| Medicare Enrollment ID | O20220607001111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083890917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 55451 (California) | Primary |
| Provider Name | Sang Eun Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1689850315 PECOS PAC ID: 7810375672 Enrollment ID: I20220607001266 |
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