Most Relevant Information
Provider Data
| NPI Number: | 1003031402 |
| Provider Name: | DAVID FORMOSAN LEE DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 50 053083 |
Most Important Dates
| Enumeration Date: | 04/13/2007 |
| Last Updated: | 06/08/2020 |
Provider Practice Location
30 E 40TH ST RM 305
NEW YORK
NY
100161247
Practice Location Phone/Fax
| Phone: | 2123701919 |
| Fax: |
Provider Mailing Location
4436 TIMBERLAKE DRIVE
LOUISVILLE
TN
37777
Provider Mailing Phone/Fax
| Phone: | 8659702821 |
| Fax: | 8659830870 |