Provider Demographics
NPI:1912044041
Name:LEE, GREGORY SCOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOT
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:51 INVERLEITH TER
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3322
Mailing Address - Country:US
Mailing Address - Phone:510-796-8888
Mailing Address - Fax:510-796-0397
Practice Address - Street 1:4101 DUBLIN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4592
Practice Address - Country:US
Practice Address - Phone:925-803-5888
Practice Address - Fax:925-803-7688
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CADE0367851223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery