Provider Demographics
NPI:1457578700
Name:CAUSEY C. LEE, D.D.S., P.A.
Entity Type:Organization
Organization Name:CAUSEY C. LEE, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAUSEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:305-558-3384
Mailing Address - Street 1:1790 W 49TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2992
Mailing Address - Country:US
Mailing Address - Phone:305-558-3384
Mailing Address - Fax:305-828-5726
Practice Address - Street 1:1790 W 49TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2992
Practice Address - Country:US
Practice Address - Phone:305-558-3384
Practice Address - Fax:305-828-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN52241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty