Provider Demographics
NPI:1144229618
Name:LEE, BENJAMIN PHILIP (DDS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:PHILIP
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 1:270 LITTLETON RD
Mailing Address - Street 2:STE 33-34
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3526
Mailing Address - Country:US
Mailing Address - Phone:978-692-6771
Mailing Address - Fax:978-692-4774
Practice Address - Street 1:270 LITTLETON RD
Practice Address - Street 2:STE 33-34
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3526
Practice Address - Country:US
Practice Address - Phone:978-692-6771
Practice Address - Fax:978-692-4774
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11115122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist