Provider Demographics
NPI:1003379264
Name:SHIRLEY T LEE AND ASSOCIATES A DENTAL CORP
Entity Type:Organization
Organization Name:SHIRLEY T LEE AND ASSOCIATES A DENTAL CORP
Other - Org Name:ANAHEIM SMILES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:657-341-3700
Mailing Address - Street 1:5475 E LA PALMA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2075
Mailing Address - Country:US
Mailing Address - Phone:657-341-3700
Mailing Address - Fax:657-341-3701
Practice Address - Street 1:5475 E LA PALMA AVE STE 200
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2075
Practice Address - Country:US
Practice Address - Phone:657-341-3700
Practice Address - Fax:657-341-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty