Provider Demographics
NPI:1407903131
Name:LEE, GRACE UNEHAE (MD DMD)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:UNEHAE
Last Name:LEE
Suffix:
Gender:F
Credentials:MD DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2398 FAIR OAKS BLVD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-283-8818
Mailing Address - Fax:916-283-8815
Practice Address - Street 1:3604 FAIR OAKS BLVD
Practice Address - Street 2:SUITE 1A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-7256
Practice Address - Country:US
Practice Address - Phone:916-283-8818
Practice Address - Fax:916-283-8815
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC517141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery