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General NPI Number Information
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NPI Number | 1861838930
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Entity Type | Organization
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Legal Business Name | DANIEL LEE
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 10416 COUSER WAY
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City | VALLEY CENTER
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State | CA
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Zip | 92082-3018
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Country | US
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Telephone | 760-742-3058
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Fax |
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Provider Business Mailing Address
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Address Line | 10416 COUSER WAY
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City | VALLEY CENTER
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State | CA
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Zip | 92082-3018
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Country | US
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Telephone | 760-742-3058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL J. LEE
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Credential | DDS
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Telephone | 760-742-3058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 23634
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License Number State | CA
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