MEDICARE: DR. LEE ALLLEN MAHLMANN DDS, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	11435	TX

General Provider Information

NPI Number	:	1295940591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE ALLLEN MAHLMANN DDS, MS

Provider Business Mailing Address
First Line	:	1310 THOMPSON RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-4245
Country	:	US
Telephone Number	:	281-342-6311
Fax Number	:	281-232-2359

Provider Business Practice Location Address
First Line	:	1310 THOMPSON RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-4245
Country	:	US
Telephone Number	:	281-342-6311
Fax Number	:	281-232-2359

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

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	09/24/2008

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