Provider Demographics
NPI:1790200822
Name:LEE, APRIL (DMD)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8935
Mailing Address - Country:US
Mailing Address - Phone:727-290-0929
Mailing Address - Fax:727-290-0919
Practice Address - Street 1:1621 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8935
Practice Address - Country:US
Practice Address - Phone:727-290-0929
Practice Address - Fax:727-290-0919
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN229711223G0001X
TX333971223G0001X
FL229711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice