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General NPI Number Information
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NPI Number | 1750581138
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Entity Type | Organization
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Legal Business Name | STEVE SHIH-IN LEE A PROF DENTAL CORP
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 229 S MISSION DR
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1125
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Country | US
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Telephone | 626-281-2012
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Fax |
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Provider Business Mailing Address
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Address Line | 229 S MISSION DR
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1125
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Country | US
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Telephone | 626-281-2012
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVE SHIH-IN LEE
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Credential | DDS
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Telephone | 562-640-0898
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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 | 48495
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License Number State | CA
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