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General NPI Number Information
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NPI Number | 1396105060
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Entity Type | Organization
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Legal Business Name | SHAWN LEE AND MANORANJANI SAMBANGI DENTAL CORPORATION
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 28901 S WESTERN AVE STE 131
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-0824
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Country | US
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Telephone | 310-750-2470
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Fax | 310-817-6068
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Provider Business Mailing Address
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Address Line | 17000 RED HILL AVENUE
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City | IRVINE
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State | CA
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Zip | 92614
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Country | US
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Telephone | 714-845-8890
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Fax | 949-474-1495
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. SHAWN LEE
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Credential | DDS
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Telephone | 310-750-2470
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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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