Provider Demographics
NPI:1336857960
Name:P Z LEE DMD DENTAL CORPORATION
Entity Type:Organization
Organization Name:P Z LEE DMD DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-802-9552
Mailing Address - Street 1:600 W MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3336
Mailing Address - Country:US
Mailing Address - Phone:626-282-4119
Mailing Address - Fax:
Practice Address - Street 1:600 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3336
Practice Address - Country:US
Practice Address - Phone:626-282-4119
Practice Address - Fax:626-782-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental