Healthcare Provider Details

I. General information

NPI: 1457578700
Provider Name (Legal Business Name): CAUSEY C. LEE, D.D.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 W 49TH ST SUITE 110
HIALEAH FL
33012-2992
US

IV. Provider business mailing address

1790 W 49TH ST SUITE 110
HIALEAH FL
33012-2992
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-3384
  • Fax: 305-828-5726
Mailing address:
  • Phone: 305-558-3384
  • Fax: 305-828-5726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN5224
License Number StateFL

VIII. Authorized Official

Name: DR. CAUSEY C. LEE JR.
Title or Position: OWNER
Credential: D.D.S., P.A.
Phone: 305-558-3384