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NPI 1154495802

IndividualActive

Brent Lee, D.D.S., M.S.

NPI 1154495802 · Oral and Maxillofacial Surgery (Dentist) · Pocatello, ID

Provider details

NPI number: 1154495802
Entity type: Individual
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Credential: D.D.S., M.S.
Sex: Male
Sole proprietor: No
License: D1494 (ID)

Practice location

165 N 14th Ave

Pocatello, ID 83201-4146

Phone: (208) 232-2807

Fax: (208) 232-8118

More ID providers

Mailing address

Po Box 6033

Pocatello, ID 83205-6033

Registry dates

Enumerated: 2006-11-17
Last updated: 2007-07-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Brent Lee, D.D.S., M.S. — NPI 1154495802, Pocatello, ID | NPI Central