Provider Demographics
NPI:1184765703
Name:TEE, DANIEL (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:TEE
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 1:6000 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3266
Mailing Address - Country:US
Mailing Address - Phone:480-820-6131
Mailing Address - Fax:
Practice Address - Street 1:6000 S MCCLINTOCK DR
Practice Address - Street 2:SUITE B
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3266
Practice Address - Country:US
Practice Address - Phone:480-820-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7035122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD7035Medicaid