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General NPI Number Information
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NPI Number | 1215719430
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Entity Type | Organization
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Legal Business Name | SAMUEL LEE DMD PLLC
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 604 COUNTY RD
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City | HANSON
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State | MA
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Zip | 02341-1668
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Country | US
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Telephone | 781-294-8022
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Fax |
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Provider Business Mailing Address
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Address Line | 27 HOWLAND ST UNIT 8
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City | PLYMOUTH
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State | MA
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Zip | 02360-4998
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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. SAMUEL ROBERT LEE
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Credential | DMD
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Telephone | 407-375-7176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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