Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 047793 | GA |
NPI | 1033153671 |
---|---|
Provider Name | Dr. Joyce T Lee |
First Address | Atlanta, GA 30361-6202 |
Second Address | Atlanta, GA 30361-6202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H49568 | (02) |