Lee, Jungwoo

Lee, Jungwoo is an individual health care provider with primary practice located at 11160 Medlock Bridge Rd , Duluth GA 30097-2641. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Lee, Jungwoo can be contacted via phone (770) 847-7690.

Contact Information

Primary practice address
11160 Medlock Bridge Rd Duluth GA 30097-2641
Phone: (770) 847-7690
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 12010693 Indiana
Dental Providers / General Practice 1223G0001X D008679 Arizona
Dental Providers / Dentist 122300000X DN123077 Georgia

Profile Details

NPI number 1710923537
LBN Legal business name Lee, Jungwoo
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Oct 18th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710923537 NPPES
Indiana MEDICAID 200501900

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