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NPI Code Detail

MEDICARE: MS. SUZANNA NGOC LEE D.D.S.,M.A.G.D.

MEDICARE: MS. SUZANNA NGOC LEE D.D.S.,M.A.G.D.
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
1122300000XDentist244728CA

General Provider Information

NPI Number : 1477737260
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZANNA NGOC LEE D.D.S.,M.A.G.D.
Provider Business Mailing Address
First Line : 570 N SHORELINE BLVD STE G
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94043-3106
Country : US
Telephone Number : 650-988-9998
Fax Number : 650-988-7095
Provider Business Practice Location Address
First Line : 570 N SHORELINE BLVD STE G
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94043-3106
Country : US
Telephone Number : 650-988-9998
Fax Number : 650-988-7095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2007
Last Update Date : 09/30/2008

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