Provider Demographics
NPI:1679546741
Name:LEE, MICHAEL HECHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HECHAN
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 1:19745 COLIMA RD
Mailing Address - Street 2:SUITE NUMBER#E-10
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3219
Mailing Address - Country:US
Mailing Address - Phone:909-594-9303
Mailing Address - Fax:909-594-0137
Practice Address - Street 1:19745 COLIMA RD
Practice Address - Street 2:SUITE NUMBER#E-10
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3219
Practice Address - Country:US
Practice Address - Phone:909-594-9303
Practice Address - Fax:909-594-0137
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA287471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB2874702OtherSECOND OFFICE