Provider Demographics
NPI:1073727236
Name:LEE, HENRY H (DDS)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:H
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17021 YORBA LINDA BLVD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3743
Mailing Address - Country:US
Mailing Address - Phone:714-524-1836
Mailing Address - Fax:
Practice Address - Street 1:17021 YORBA LINDA BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3743
Practice Address - Country:US
Practice Address - Phone:714-524-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice