Lee, Timothy Dae

Lee, Timothy Dae is an individual health care provider with primary practice located at 4021 Rhea Rd , Wichita Falls TX 76308-2727. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Lee, Timothy Dae can be contacted via phone (214) 923-0648.

Contact Information

Primary practice address
4021 Rhea Rd Wichita Falls TX 76308-2727
Phone: (214) 923-0648
Fax: (940) 613-0213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 22042 Texas
Dental Providers / Pediatric Dentistry 1223P0221X 80 Oklahoma

Profile Details

NPI number 1982638359
LBN Legal business name Lee, Timothy Dae
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Mar 7th, 2016 - about 9 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 1982638359 NPPES
Oklahoma MEDICAID 200131900 A
Oklahoma MEDICAID 5441000
Oklahoma MEDICAID 1701203-10

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