Provider Demographics
NPI:1720218282
Name:LEE, ELIZABETH ANDERSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANDERSON
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 1:5700 OLD RICHMOND AVE
Mailing Address - Street 2:SUITE D-17
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1828
Mailing Address - Country:US
Mailing Address - Phone:804-288-4526
Mailing Address - Fax:804-288-3756
Practice Address - Street 1:5700 OLD RICHMOND AVE
Practice Address - Street 2:SUITE D-17
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1828
Practice Address - Country:US
Practice Address - Phone:804-288-4526
Practice Address - Fax:804-288-3756
Is Sole Proprietor?:No
Enumeration Date:2009-07-19
Last Update Date:2009-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA74691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice