Provider Demographics
NPI:1316035983
Name:LEE, RICHARD C (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
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 1:1298 KIFER RD
Mailing Address - Street 2:#501
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-5319
Mailing Address - Country:US
Mailing Address - Phone:408-830-0123
Mailing Address - Fax:
Practice Address - Street 1:1298 KIFER RD
Practice Address - Street 2:#501
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5319
Practice Address - Country:US
Practice Address - Phone:408-830-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557311223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics