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General NPI Number Information
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NPI Number | 1528292190
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Entity Type | Organization
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Legal Business Name | DANNY I LEE, DMD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 19019 HAWTHORNE BLVD STE 100B
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City | TORRANCE
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State | CA
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Zip | 90503-1524
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Country | US
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Telephone | 310-371-0113
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Fax | 310-371-1927
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Provider Business Mailing Address
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Address Line | 19019 HAWTHORNE BLVD STE 100B
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City | TORRANCE
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State | CA
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Zip | 90503-1524
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Country | US
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Telephone | 310-371-0113
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Fax | 310-371-1927
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. DANNY I LEE
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Credential | DMD
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Telephone | 310-371-0113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 47114
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License Number State | CA
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