MEDICARE: DR. DANIEL I 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	1223G0001X	General Practice Dentistry	37249	CA

General Provider Information

NPI Number	:	1417046335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL I LEE DDS

Provider Business Mailing Address
First Line	:	4200 CHINO HILLS PKWY
Second Line	:	SUITE 880
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3776
Country	:	US
Telephone Number	:	909-393-5456
Fax Number	:	909-393-2051

Provider Business Practice Location Address
First Line	:	4200 CHINO HILLS PKWY
Second Line	:	SUITE 880
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3776
Country	:	US
Telephone Number	:	909-393-5456
Fax Number	:	909-393-2051

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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