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General NPI Number Information
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NPI Number | 1982681011
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Entity Type | Individual
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Provider Name | BRUCE W LEE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 795 S 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-3322
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Country | US
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Telephone | 928-428-2750
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Fax |
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Provider Business Mailing Address
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Address Line | 3175 W CHURCH ST
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City | THATCHER
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State | AZ
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Zip | 85552-5667
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Country | US
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Telephone | 720-244-9337
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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 | D011697
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 106350
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License Number State | CO
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