Provider Demographics
NPI:1083827026
Name:HAUER, LEE SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:SCOTT
Last Name:HAUER
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 1:4350 SHERIDAN ST
Mailing Address - Street 2:SUITE 201D
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3556
Mailing Address - Country:US
Mailing Address - Phone:954-981-0012
Mailing Address - Fax:954-986-9966
Practice Address - Street 1:4350 SHERIDAN ST
Practice Address - Street 2:SUITE 201D
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3556
Practice Address - Country:US
Practice Address - Phone:954-981-0012
Practice Address - Fax:954-986-9966
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL96231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics