Provider Demographics
NPI:1225300668
Name:LEE, CHRISTINE NAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:NAM
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9381 E STOCKTON BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5068
Mailing Address - Country:US
Mailing Address - Phone:916-686-4212
Mailing Address - Fax:916-686-4217
Practice Address - Street 1:9381 E STOCKTON BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5068
Practice Address - Country:US
Practice Address - Phone:916-686-4212
Practice Address - Fax:916-686-4217
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20093122300000X
CA61952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist