Provider Demographics
NPI:1750340725
Name:LEE, BEN S (DDS)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:S
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 1:44750 60TH ST W
Mailing Address - Street 2:HEALTHCARE SERVICES - DENTAL DEPARTMENT
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-7619
Mailing Address - Country:US
Mailing Address - Phone:661-729-2000
Mailing Address - Fax:
Practice Address - Street 1:44750 60TH ST W
Practice Address - Street 2:HEALTHCARE SERVICES - DENTAL DEPARTMENT
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-7619
Practice Address - Country:US
Practice Address - Phone:661-729-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54487122300000X
MI29010180661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist