Provider Demographics
NPI:1376670943
Name:LEE, LINDA SMITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SMITH
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 1:429 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2045
Mailing Address - Country:US
Mailing Address - Phone:607-432-2187
Mailing Address - Fax:607-432-2415
Practice Address - Street 1:429 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2045
Practice Address - Country:US
Practice Address - Phone:607-432-2187
Practice Address - Fax:607-432-2415
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist