| Lee Family Dentstry, Llc | |
|
138 Battlewood Dr Fort Oglethorpe GA 30742-4006 | |
| (706) 686-6011 | |
| (706) 820-6854 |
| Full Name | Lee Family Dentstry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 138 Battlewood Dr, Fort Oglethorpe, Georgia |
| Authorized Official Name and Position | Jacob Lee (OWNER) |
| Authorized Official Contact | 7066866011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Family Dentstry, Llc 138 Battlewood Dr Fort Oglethorpe GA 30742-4006 Ph: () - | Lee Family Dentstry, Llc 138 Battlewood Dr Fort Oglethorpe GA 30742-4006 Ph: (706) 686-6011 |
| NPI Number | 1720465602 |
|---|---|
| Provider Enumeration Date | 04/30/2015 |
| Last Update Date | 04/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720465602 | NPI | - | NPPES |
| 000583085C | Medicaid | GA | |
| 076800461B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN011116 (Georgia) | Secondary |
| 1223G0001X | Dentist - General Practice | DN013134 (Georgia) | Primary |
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