MEDICARE: DR. TIMOTHY M LEE DDS MS

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
1	1223G0001X	General Practice Dentistry	DN23978	FL

General Provider Information

NPI Number	:	1538322888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY M LEE DDS MS

Provider Business Mailing Address
First Line	:	1500 PRICE CREEK WAY
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-2414
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 PRICE CREEK WAY
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-2414
Country	:	US
Telephone Number	:	941-200-5094
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	02/10/2026

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