Provider Demographics
NPI:1548037567
Name:LEE, CHRISTIN (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 165TH AVENUE CT E # 206-313
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-4927
Mailing Address - Country:US
Mailing Address - Phone:206-313-6539
Mailing Address - Fax:
Practice Address - Street 1:12900 JOSEY LN STE 140
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-6564
Practice Address - Country:US
Practice Address - Phone:972-243-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60658516122300000X
TX40734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist