Provider Demographics
NPI:1851454193
Name:LEE, RAYMOND T (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:T
Last Name:LEE
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 1:7840 GLADES RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4102
Mailing Address - Country:US
Mailing Address - Phone:561-482-2005
Mailing Address - Fax:561-482-2126
Practice Address - Street 1:7840 GLADES RD
Practice Address - Street 2:SUITE 235
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4102
Practice Address - Country:US
Practice Address - Phone:561-482-2005
Practice Address - Fax:561-482-2126
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice