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General NPI Number Information
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NPI Number | 1912787052
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Entity Type | Individual
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Provider Name | SIDNEY JUN LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1970 N MAIN ST
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City | SALINAS
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State | CA
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Zip | 93906-2036
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Country | US
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Telephone | 831-424-4230
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Fax | 831-204-7748
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Provider Business Mailing Address
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Address Line | 154 CASENTINI ST APT G
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City | SALINAS
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State | CA
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Zip | 93907-2286
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Country | US
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Telephone | 630-441-6738
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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 | 109451
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License Number State | CA
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