Provider Demographics
NPI:1639297708
Name:STEVE S LEE, PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:STEVE S LEE, PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-993-2550
Mailing Address - Street 1:302 E PALM DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3233
Mailing Address - Country:US
Mailing Address - Phone:714-993-2550
Mailing Address - Fax:
Practice Address - Street 1:302 E PALM DR
Practice Address - Street 2:SUITE C
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3233
Practice Address - Country:US
Practice Address - Phone:714-993-2550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty