Provider Demographics
NPI:1508075292
Name:LEE, ARLENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N LOS ANGELES ST
Mailing Address - Street 2:#10A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3307
Mailing Address - Country:US
Mailing Address - Phone:213-626-3706
Mailing Address - Fax:213-626-3707
Practice Address - Street 1:201 N LOS ANGELES ST
Practice Address - Street 2:#10A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3307
Practice Address - Country:US
Practice Address - Phone:213-626-3706
Practice Address - Fax:213-626-3707
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA245691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice