MEDICARE: BENJAMIN PHILIP LEE DDS

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	122300000X	Dentist	11115	MA

General Provider Information

NPI Number	:	1144229618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN PHILIP LEE DDS

Provider Business Mailing Address
First Line	:	270 LITTLETON RD
Second Line	:	STE 33-34
City	:	WESTFORD
State	:	MA
Zip	:	01886-3526
Country	:	US
Telephone Number	:	978-692-6771
Fax Number	:	978-692-4774

Provider Business Practice Location Address
First Line	:	270 LITTLETON RD
Second Line	:	STE 33-34
City	:	WESTFORD
State	:	MA
Zip	:	01886-3526
Country	:	US
Telephone Number	:	978-692-6771
Fax Number	:	978-692-4774

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/08/2007

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