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General NPI Number Information
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NPI Number | 1194193680
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Entity Type | Organization
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Legal Business Name | GARRETT A. LEE DDS, INC.
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 8241 BRUCEVILLE RD SUITE 180
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City | SACRAMENTO
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State | CA
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Zip | 95823-2365
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Country | US
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Telephone | 808-783-7174
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Fax |
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Provider Business Mailing Address
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Address Line | 8241 BRUCEVILLE RD SUITE 180
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City | SACRAMENTO
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State | CA
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Zip | 95823-2365
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Country | US
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Telephone | 808-783-7174
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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. GARRETT ADAM LEE
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Credential | DDS
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Telephone | 808-783-7174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 59955
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License Number State | CA
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