Provider Demographics
NPI:1902824121
Name:LEE, DAVID B (DDS PA)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 UNIVERSITY BLVD W
Mailing Address - Street 2:SUITE G4
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3351
Mailing Address - Country:US
Mailing Address - Phone:301-649-5001
Mailing Address - Fax:301-681-8132
Practice Address - Street 1:1111 UNIVERSITY BLVD W
Practice Address - Street 2:SUITE G4
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3351
Practice Address - Country:US
Practice Address - Phone:301-649-5001
Practice Address - Fax:301-681-8132
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice