| Sung Kyu Lee Dds Inc | |
|
2125 S Brea Canyon Rd Diamond Bar CA 91765-4019 | |
| (213) 308-1188 | |
| Not Available |
| Full Name | Sung Kyu Lee Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 2125 S Brea Canyon Rd, Diamond Bar, California |
| Authorized Official Name and Position | Sung Kyu Lee (DENTIST) |
| Authorized Official Contact | 2133081188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sung Kyu Lee Dds Inc 2125 S Brea Canyon Rd Diamond Bar CA 91765-4019 Ph: (213) 308-1188 | Sung Kyu Lee Dds Inc 2125 S Brea Canyon Rd Diamond Bar CA 91765-4019 Ph: (213) 308-1188 |
| NPI Number | 1043764293 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 01/31/2017 |
| Medicare PECOS PAC ID | 4981980653 |
|---|---|
| Medicare Enrollment ID | O20170411002682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043764293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 61684 (California) | Primary |
| Provider Name | Sung Kyu Lee |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1316305048 PECOS PAC ID: 8729369269 Enrollment ID: I20170112000388 |
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