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General NPI Number Information
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NPI Number | 1356462584
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Entity Type | Organization
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Legal Business Name | NANCY LEE, D.D.S. INC.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2901 W OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91505-4536
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Country | US
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Telephone | 818-563-9888
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Fax | 818-563-2888
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Provider Business Mailing Address
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Address Line | 2901 W OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91505-4536
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Country | US
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Telephone | 818-563-9888
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Fax | 818-563-2888
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Authorized Official
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Title or Position | OWNER
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Name | NANCY LEE
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Credential | D.D.S.
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Telephone | 818-563-9888
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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 | 32241
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License Number State | CA
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