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General NPI Number Information
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NPI Number | 1205310182
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Entity Type | Individual
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Provider Name | DANIEL LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 5900 STATE FARM DR FL 2
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City | ROHNERT PARK
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State | CA
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Zip | 94928-2149
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Country | US
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Telephone | 707-559-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 43913 S MORAY ST
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City | FREMONT
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State | CA
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Zip | 94539-5942
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Country | US
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Telephone | 510-579-3772
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34601
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 102944
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License Number State | CA
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