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General NPI Number Information
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NPI Number | 1659427052
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Entity Type | Individual
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Provider Name | CHRISTIAN KINGSTON LEE D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 734 MIDDLEFIELD RD
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City | PALO ALTO
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State | CA
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Zip | 94301-2911
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Country | US
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Telephone | 650-289-9200
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Fax | 650-289-9582
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Provider Business Mailing Address
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Address Line | 324 37TH AVE
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City | SAN MATEO
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State | CA
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Zip | 94403-4327
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Country | US
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Telephone | 650-533-0679
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Fax | 650-458-6441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 50157
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License Number State | CA
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