Provider Demographics
NPI:1760536098
Name:LEE, SAMSON FU KEUNG (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMSON
Middle Name:FU KEUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 MISSION ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-3762
Mailing Address - Country:US
Mailing Address - Phone:415-333-0106
Mailing Address - Fax:650-948-9340
Practice Address - Street 1:5301 MISSION ST
Practice Address - Street 2:SUITE A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-3762
Practice Address - Country:US
Practice Address - Phone:415-333-0106
Practice Address - Fax:650-948-9340
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist