Provider Demographics
NPI:1457419798
Name:LEE, AARON KENDALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:KENDALL
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 1:2151SALVIO
Mailing Address - Street 2:SUITE A1
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-0000
Mailing Address - Country:US
Mailing Address - Phone:510-710-8011
Mailing Address - Fax:
Practice Address - Street 1:2151 SALVIO ST
Practice Address - Street 2:SUITE A1
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2451
Practice Address - Country:US
Practice Address - Phone:510-710-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice