Provider Demographics
NPI:1770506719
Name:LEE, BARBRA JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARBRA
Middle Name:JEAN
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 1:1371 7TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-4205
Mailing Address - Country:US
Mailing Address - Phone:651-222-0351
Mailing Address - Fax:651-222-1556
Practice Address - Street 1:1371 7TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-4205
Practice Address - Country:US
Practice Address - Phone:651-222-0351
Practice Address - Fax:651-222-1556
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice