Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 1201047613 | IN |
NPI | 1124120274 |
---|---|
Provider Name | Dr. Shelly Ling-Chin Lee |
First Address | Carmel, IN 46032-3581 |
Second Address | Carmel, IN 46032-3581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 08/07/2007 |