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General NPI Number Information
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NPI Number | 1841417391
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Entity Type | Individual
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Provider Name | SUSAN THUYMINH LEE D. D. S.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 2726 ABORN RD STE. K
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City | SAN JOSE
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State | CA
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Zip | 95121-1276
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Country | US
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Telephone | 408-270-7723
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Fax | 408-223-8717
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Provider Business Mailing Address
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Address Line | 2726 ABORN RD STE. K
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City | SAN JOSE
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State | CA
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Zip | 95121-1276
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Country | US
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Telephone | 408-270-7723
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Fax | 408-223-8717
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 47750
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License Number State | CA
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