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General NPI Number Information
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NPI Number | 1912041385
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Entity Type | Organization
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Legal Business Name | CANDICE HUI-YUN LEE
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 E LINCOLN AVE SUITE 105
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City | ANAHEIM
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State | CA
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Zip | 92805-3202
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Country | US
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Telephone | 714-774-7761
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 168
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City | ANAHEIM
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State | CA
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Zip | 92815-0168
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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 | OWNER
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Name | CANDICE HUI-YUN LEE
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Credential |
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Telephone | 714-774-7761
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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 | 29962
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License Number State | CA
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