Provider Demographics
NPI:1639272834
Name:LEE, ANNE R (DDS)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:R
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 1:1475 HUNTINGTON AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5990
Mailing Address - Country:US
Mailing Address - Phone:560-873-5212
Mailing Address - Fax:650-873-8877
Practice Address - Street 1:1475 HUNTINGTON AVE
Practice Address - Street 2:STE 150
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5990
Practice Address - Country:US
Practice Address - Phone:560-873-5212
Practice Address - Fax:650-873-8877
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS483121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry