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Brent D Lee, DDS,MS
Oral and Maxillofacial Surgery (Dentist) in Pocatello, Idaho
NPI 1154495802

Brent D Lee is a Oral and Maxillofacial Surgery (Dentist) based in Pocatello, ID and is specialized in Oral and Maxillofacial Surgery. Brent D Lee practices in Pocatello, ID and has the professional credentials of DDS,MS. The NPI Number for Brent D Lee is 1154495802 and holds a License No. D1494 (Idaho).

The current practice location address for Brent D Lee is 165 N 14Th Ave, Pocatello, ID and can be reached out via phone at 208-232-2807 and via fax at 208-232-8118.

Location: 165 N 14Th Ave, Pocatello, ID, 83205-6033
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Provider Profile Details
NPI Number
1154495802
Provider Name
Brent D Lee
Credential
DDS,MS
Provider Entity Type
Individual
Gender
Male
Address
165 N 14Th Ave, Pocatello, ID, 83205-6033
Phone Number
208-232-2807
Fax Number
208-232-8118
Provider Enumeration Date
11/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000010009592 01 ID RAILROAD
6M097 01 ID BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
165 N 14Th Ave
City
State
Zip
83201-4146
Phone Number
208-232-2807
Fax Number
208-232-8118
person
Provider Business Mailing Address Details
Address
165 N 14Th Ave
City
State
Zip
83201-4146
Phone Number
208-232-2807
Fax Number
208-232-8118
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
D1494 (Idaho)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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