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General NPI Number Information
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NPI Number | 1356652564
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Entity Type | Organization
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Legal Business Name | NOMI LEE DDS INC
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 701 HIGHLAND SPRINGS AVE SUITE 11
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City | BEAUMONT
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State | CA
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Zip | 92223-2550
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Country | US
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Telephone | 909-522-7815
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Fax |
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Provider Business Mailing Address
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Address Line | 701 HIGHLAND SPRINGS AVE SUITE 11
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City | BEAUMONT
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State | CA
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Zip | 92223-2550
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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 | NOMI LEE
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Credential |
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Telephone | 909-522-7815
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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 |
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License Number State |
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