Provider Demographics
NPI:1164566634
Name:LEE, PHYLLIS CALLAHAN (DMD, MDS)
Entity Type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:CALLAHAN
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 WASHINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1909
Mailing Address - Country:US
Mailing Address - Phone:412-343-9100
Mailing Address - Fax:412-343-9101
Practice Address - Street 1:603 WASHINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1909
Practice Address - Country:US
Practice Address - Phone:412-343-9100
Practice Address - Fax:412-343-9101
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027906L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics