Provider Demographics
NPI:1275659070
Name:LEE, VICTOR THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:THOMAS
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 1:3501 CALIFORNIA ST # 201
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1707
Mailing Address - Country:US
Mailing Address - Phone:415-751-1101
Mailing Address - Fax:
Practice Address - Street 1:3501 CALIFORNIA ST # 201
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1707
Practice Address - Country:US
Practice Address - Phone:415-751-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics