Provider Demographics
NPI:1104017771
Name:LEE-MCDANIEL, UN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:UN
Middle Name:T
Last Name:LEE-MCDANIEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 DESERT WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-1127
Mailing Address - Country:US
Mailing Address - Phone:760-325-7158
Mailing Address - Fax:760-327-4283
Practice Address - Street 1:515 DESERT WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1127
Practice Address - Country:US
Practice Address - Phone:760-325-7158
Practice Address - Fax:760-327-4283
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA434581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43458OtherDENTAL INSURANCE