Provider Demographics
NPI:1336112721
Name:SLATER, LEE JAMES (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:JAMES
Last Name:SLATER
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:11377 LEGACY CANYON PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3524
Mailing Address - Country:US
Mailing Address - Phone:858-587-3997
Mailing Address - Fax:
Practice Address - Street 1:5190 GOVERNOR DR
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-2847
Practice Address - Country:US
Practice Address - Phone:858-784-0600
Practice Address - Fax:858-784-0604
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA250321223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology