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General NPI Number Information
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NPI Number | 1457763716
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Entity Type | Organization
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Legal Business Name | LUKE B. LEE, DMD INC.
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 15632 S NORMANDIE AVE
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City | GARDENA
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State | CA
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Zip | 90247-4016
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Country | US
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Telephone | 310-532-5232
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Fax | 310-532-6908
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Provider Business Mailing Address
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Address Line | 15632 S NORMANDIE AVE
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City | GARDENA
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State | CA
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Zip | 90247-4016
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Country | US
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Telephone | 310-532-5232
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Fax | 310-532-6908
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SEH YOUNG LEE
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Credential |
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Telephone | 213-210-8506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 55251
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License Number State | CA
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