Provider Demographics
NPI:1255304036
Name:LEE, EUNICE P (DMD,MPH,MS)
Entity type:Individual
Prefix:DR
First Name:EUNICE
Middle Name:P
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD,MPH,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8199 SOUTHPARK LN
Mailing Address - Street 2:SUITE #150
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4530
Mailing Address - Country:US
Mailing Address - Phone:303-738-8828
Mailing Address - Fax:303-738-8823
Practice Address - Street 1:8199 SOUTHPARK LN
Practice Address - Street 2:SUITE #150
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4530
Practice Address - Country:US
Practice Address - Phone:303-738-8828
Practice Address - Fax:303-738-8823
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO79241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60387831Medicaid