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NPI Code Detail

MEDICARE: LEE AND NOSTI DENTAL CORPORATION

MEDICARE: LEE AND NOSTI DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1033385455
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEE AND NOSTI DENTAL CORPORATION
Provider Business Mailing Address
First Line : 17000 RED HILL AVE
Second Line :
City : IRVINE
State : CA
Zip : 92614-5626
Country : US
Telephone Number : 714-845-8890
Fax Number : 303-952-0892
Provider Business Practice Location Address
First Line : 1643 S SAN JACINTO AVE STE 100&101
Second Line :
City : SAN JACINTO
State : CA
Zip : 92583-5181
Country : US
Telephone Number : 951-654-7744
Fax Number : 951-654-6823
Authorized Official
Title or Position : OWNER DOCTOR
Name : DR. DAVID Y LEE
Credential : DDS
Telephone Number : 951-654-7744
Provider Enumeration Date : 05/06/2008
Last Update Date : 10/07/2019

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Directions to “LEE AND NOSTI DENTAL CORPORATION ” Practice Location

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