Provider Demographics
NPI:1518159508
Name:LEE, STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
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 1:881 ALMA REAL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3731
Mailing Address - Country:US
Mailing Address - Phone:310-459-9833
Mailing Address - Fax:310-459-9834
Practice Address - Street 1:881 ALMA REAL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3731
Practice Address - Country:US
Practice Address - Phone:310-459-9833
Practice Address - Fax:310-459-9834
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48741122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist