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General NPI Number Information
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NPI Number | 1144365503
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Entity Type | Organization
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Legal Business Name | CHEN & LEE DENTAL
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3967 RIVERMARK PLZ
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City | SANTA CLARA
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State | CA
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Zip | 95054-4156
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Country | US
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Telephone | 408-988-1588
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Fax |
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Provider Business Mailing Address
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Address Line | 3967 RIVERMARK PLZ
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City | SANTA CLARA
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State | CA
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Zip | 95054-4156
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TOMMY P LEE
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Credential | DMD
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Telephone | 408-988-1588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 48309
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License Number State | CA
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