Provider Demographics
NPI:1801854526
Name:OCKNER, LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:
Last Name:OCKNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29800 HARPER AVE
Mailing Address - Street 2:#1
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-1655
Mailing Address - Country:US
Mailing Address - Phone:586-294-1010
Mailing Address - Fax:586-294-0314
Practice Address - Street 1:29800 HARPER AVE
Practice Address - Street 2:#1
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-1655
Practice Address - Country:US
Practice Address - Phone:586-294-1010
Practice Address - Fax:586-294-0314
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010154151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice