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General NPI Number Information
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NPI Number | 1902319676
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Entity Type | Individual
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Provider Name | JANICE SOOK LEE DDS
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Gender | Female
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 8247 WHITTIER BLVD
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City | PICO RIVERA
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State | CA
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Zip | 90660-2527
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Country | US
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Telephone | 323-724-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 107 N OAK AVE UNIT 12
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City | PASADENA
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State | CA
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Zip | 91107-5822
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Country | US
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Telephone |
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS101894
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License Number State | CA
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