Provider Demographics
NPI:1821351644
Name:STEVEN K. LEE. D.D.S. INC.
Entity Type:Organization
Organization Name:STEVEN K. LEE. D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-289-4473
Mailing Address - Street 1:823 S. ATLANTIC BLVD.
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4721
Mailing Address - Country:US
Mailing Address - Phone:626-289-4473
Mailing Address - Fax:626-289-4474
Practice Address - Street 1:823 S. ATLANTIC BLVD.
Practice Address - Street 2:SUITE 7
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4721
Practice Address - Country:US
Practice Address - Phone:626-289-4473
Practice Address - Fax:626-289-4474
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEVEN K. LEE, D.D.S. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA475131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty