Provider Demographics
NPI:1215383567
Name:DAN & LEE, LLC
Entity Type:Organization
Organization Name:DAN & LEE, LLC
Other - Org Name:EXPRESS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOBART
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:816-607-1006
Mailing Address - Street 1:309 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-9741
Mailing Address - Country:US
Mailing Address - Phone:816-607-1006
Mailing Address - Fax:816-278-9100
Practice Address - Street 1:309 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-9741
Practice Address - Country:US
Practice Address - Phone:816-607-1006
Practice Address - Fax:816-278-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare