Provider Demographics
NPI:1720776362
Name:LEE AND PI A GENERAL PARTNERSHIP
Entity Type:Organization
Organization Name:LEE AND PI A GENERAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-283-4389
Mailing Address - Street 1:1432 EDINGER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6293
Mailing Address - Country:US
Mailing Address - Phone:310-283-4389
Mailing Address - Fax:
Practice Address - Street 1:1432 EDINGER AVE STE 100
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6293
Practice Address - Country:US
Practice Address - Phone:310-283-4389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental