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General NPI Number Information
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NPI Number | 1396471488
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Entity Type | Organization
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Legal Business Name | LEE & LEONG DENTAL GROUP INC.
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 964 A ST
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City | HAYWARD
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State | CA
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Zip | 94541-4104
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Country | US
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Telephone | 916-916-0734
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Fax |
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Provider Business Mailing Address
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Address Line | 964 A ST
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City | HAYWARD
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State | CA
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Zip | 94541-4104
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Country | US
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Telephone | 510-398-8199
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Fax | 501-398-8194
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Authorized Official
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Title or Position | PARTNER
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Name | DR. SUSAN THUYMINH LEE
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Credential | DDS
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Telephone | 916-761-0734
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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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