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General NPI Number Information
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NPI Number | 1194403691
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Entity Type | Individual
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Provider Name | SUNSHINE LEE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 21295 S ELLSWORTH LOOP RD STE 103
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-9867
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Country | US
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Telephone | 480-445-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 3150 E RAY RD APT 341
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City | GILBERT
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State | AZ
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Zip | 85296-3101
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D011870
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License Number State | AZ
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