Provider Demographics
NPI:1700025632
Name:LEE, CHRISTINE Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:Y
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 1:3931 RIVERMARK PLAZA
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95054
Mailing Address - Country:US
Mailing Address - Phone:408-988-7788
Mailing Address - Fax:408-988-7741
Practice Address - Street 1:3931 RIVERMARK PLZ
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-4156
Practice Address - Country:US
Practice Address - Phone:408-988-7788
Practice Address - Fax:408-988-7741
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist