Individual ProviderCarter Conrad LeeDentistDental ProvidersPractice Address2360 E Stadium Blvd Ste 14, Ann Arbor, MI 48104-4887(734) 677-0793(231) 633-1378PECOS EnrollmentBased on the most recent information from CMS, provider Carter Conrad Lee does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1679202659Provider TypeIndividualFull NameLee, Carter ConradCredentialDDSGenderMaleSole ProprietorNoEnumeration Date6/6/2022Last Updated6/6/2022Contact InformationPractice LocationPractice Address2360 E Stadium Blvd Ste 14, Ann Arbor, MI 48104-4887Phone(734) 677-0793FaxUnlisted FaxMailing LocationMailing Address10495 S Tower Rd, Maple City, MI 49664-9787Phone(231) 633-1378FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense2901601275Michigan