Provider Demographics
NPI:1871998583
Name:ANDREW H. LEE, D.D.S., P.L.L.C.
Entity type:Organization
Organization Name:ANDREW H. LEE, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-235-7700
Mailing Address - Street 1:20956 39TH WAY S
Mailing Address - Street 2:B104
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-4264
Mailing Address - Country:US
Mailing Address - Phone:206-235-7700
Mailing Address - Fax:
Practice Address - Street 1:20956 39TH WAY S APT B104
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-4264
Practice Address - Country:US
Practice Address - Phone:206-235-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60289788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty