Provider Demographics
NPI:1013091537
Name:LEE, CHARLES E (DDS)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
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 1:7180 E ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1724
Mailing Address - Country:US
Mailing Address - Phone:303-741-9949
Mailing Address - Fax:303-741-9969
Practice Address - Street 1:7180 E ORCHARD RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-1724
Practice Address - Country:US
Practice Address - Phone:303-741-9949
Practice Address - Fax:303-741-9969
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice