Provider Demographics
NPI:1346217767
Name:LEE, CHRISTOPHER S (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
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 1:947 SOUTH LAKE BLVD
Mailing Address - Street 2:SUITE #A
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541
Mailing Address - Country:US
Mailing Address - Phone:845-621-2424
Mailing Address - Fax:845-621-1360
Practice Address - Street 1:947 SOUTH LAKE BLVD
Practice Address - Street 2:SUITE #A
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541
Practice Address - Country:US
Practice Address - Phone:845-621-2424
Practice Address - Fax:845-621-1360
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist