Provider Demographics
NPI:1497940001
Name:LEE, GORDON K (DDS)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:K
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 1:305 POST RD E
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3613
Mailing Address - Country:US
Mailing Address - Phone:203-226-5500
Mailing Address - Fax:203-226-5501
Practice Address - Street 1:305 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3613
Practice Address - Country:US
Practice Address - Phone:203-226-5500
Practice Address - Fax:203-226-5501
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT105771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry