Provider Demographics
NPI:1982681011
Name:LEE, BRUCE W (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:W
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:56910 E 42ND CT
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80136-8121
Mailing Address - Country:US
Mailing Address - Phone:303-400-9700
Mailing Address - Fax:303-400-3121
Practice Address - Street 1:20250 E SMOKY HILL RD UNIT 5
Practice Address - Street 2:SUITE 202
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3118
Practice Address - Country:US
Practice Address - Phone:303-400-9700
Practice Address - Fax:303-400-3121
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1063501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice