Provider Demographics
NPI:1164501417
Name:LEE, DANNY (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:
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:PO BOX 2036
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-7036
Mailing Address - Country:US
Mailing Address - Phone:925-915-0606
Mailing Address - Fax:
Practice Address - Street 1:3605 HOSPITAL ROAD
Practice Address - Street 2:SUITE H
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5173
Practice Address - Country:US
Practice Address - Phone:209-381-2047
Practice Address - Fax:209-381-2045
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD460931223G0001X
CAGA1175207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology