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NPI Code Detail

MEDICARE: DR. CLARA M LEE D.D.S.

MEDICARE:  DR. CLARA M LEE  D.D.S.
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
11223P0221XPediatric Dentistry45384CA

General Provider Information

NPI Number : 1477652097
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLARA M LEE D.D.S.
Provider Business Mailing Address
First Line : 18124 CULVER DR
Second Line : SUITE E
City : IRVINE
State : CA
Zip : 92612-2729
Country : US
Telephone Number : 949-786-0800
Fax Number :
Provider Business Practice Location Address
First Line : 18124 CULVER DR
Second Line : SUITE E
City : IRVINE
State : CA
Zip : 92612-2729
Country : US
Telephone Number : 949-786-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CLARA M LEE D.D.S.” Practice Location

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