Provider Demographics
NPI:1376758094
Name:GEE, GARY CHARLES (DDS)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:CHARLES
Last Name:GEE
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 1:14115 CRENSHAW BLVD
Mailing Address - Street 2:STE.1
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-7881
Mailing Address - Country:US
Mailing Address - Phone:310-644-0474
Mailing Address - Fax:
Practice Address - Street 1:14115 CRENSHAW BLVD
Practice Address - Street 2:STE.1
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7881
Practice Address - Country:US
Practice Address - Phone:310-644-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice