Provider Demographics
NPI:1790999688
Name:ARNEL T. LEE, DDS AND GARY H. LUM, DDS, PC
Entity Type:Organization
Organization Name:ARNEL T. LEE, DDS AND GARY H. LUM, DDS, PC
Other - Org Name:CENTRAL PARK DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:H
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-243-3748
Mailing Address - Street 1:10251 TORRE AVE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014
Mailing Address - Country:US
Mailing Address - Phone:408-243-3748
Mailing Address - Fax:408-255-0892
Practice Address - Street 1:10251 TORRE AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-243-3748
Practice Address - Fax:408-255-0892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA514791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty