Provider Demographics
NPI:1962420091
Name:LEE, ABBEY JUNE (DMD)
Entity type:Individual
Prefix:DR
First Name:ABBEY
Middle Name:JUNE
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 S ENOTA DR NE STE B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2546
Mailing Address - Country:US
Mailing Address - Phone:770-536-3254
Mailing Address - Fax:770-534-9554
Practice Address - Street 1:578 S ENOTA DR NE STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2546
Practice Address - Country:US
Practice Address - Phone:770-536-3254
Practice Address - Fax:770-534-9554
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA110661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice