MEDICARE: YAMAMOTO AND LEE, A 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
1	1223G0001X	General Practice Dentistry	31886	CA

General Provider Information

NPI Number	:	1063543429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YAMAMOTO AND LEE, A DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	2416 PROFESSIONAL DR
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-7773
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2416 PROFESSIONAL DR
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-7773
Country	:	US
Telephone Number	:	916-783-5241
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	STEVEN F LEE
Credential	:	D.D.S.
Telephone Number	:	916-783-5241

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/10/2014

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