Provider Demographics
NPI:1063441707
Name:LEE, HENRY YOUCHEE (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:YOUCHEE
Last Name:LEE
Suffix:
Gender:M
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:PO BOX 569
Mailing Address - Street 2:17721 GEORGIA AVENUE
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20830-0569
Mailing Address - Country:US
Mailing Address - Phone:301-774-2474
Mailing Address - Fax:301-570-4017
Practice Address - Street 1:17721 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2231
Practice Address - Country:US
Practice Address - Phone:301-774-2474
Practice Address - Fax:301-570-4017
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist