Provider Demographics
NPI:1881908630
Name:DEEDY-LEE, ERIN M (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:M
Last Name:DEEDY-LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10260 WASHINGTON ST
Mailing Address - Street 2:UNIT 1321
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-2053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10260 WASHINGTON ST
Practice Address - Street 2:UNIT 1321
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2053
Practice Address - Country:US
Practice Address - Phone:508-740-8129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO102191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice