Provider Demographics
NPI:1902092943
Name:LEE, WOO YOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:WOO YOUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 FILLMORE ST
Mailing Address - Street 2:STE 215
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-5236
Mailing Address - Country:US
Mailing Address - Phone:415-921-8867
Mailing Address - Fax:415-921-8868
Practice Address - Street 1:1426 FILLMORE ST
Practice Address - Street 2:STE 215
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-5236
Practice Address - Country:US
Practice Address - Phone:415-921-8867
Practice Address - Fax:415-921-8868
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA528831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice