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NPI Code Detail

MEDICARE: MRS. GRACE UNEHAE LEE MD DMD

MEDICARE: MRS. GRACE UNEHAE LEE MD DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223S0112XOral and Maxillofacial Surgery (Dentist)C51714CA

General Provider Information

NPI Number : 1407903131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GRACE UNEHAE LEE MD DMD
Provider Business Mailing Address
First Line : 2398 FAIR OAKS BLVD
Second Line : SUITE 1A
City : SACRAMENTO
State : CA
Zip : 95825
Country : US
Telephone Number : 916-283-8818
Fax Number : 916-283-8815
Provider Business Practice Location Address
First Line : 3604 FAIR OAKS BLVD
Second Line : SUITE 1A
City : SACRAMENTO
State : CA
Zip : 95864-7256
Country : US
Telephone Number : 916-283-8818
Fax Number : 916-283-8815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 05/08/2021

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