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NPI Code Detail

MEDICARE: DR. SAMUEL LEE DMD

MEDICARE:  DR. SAMUEL  LEE  DMD
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
11223G0001XGeneral Practice Dentistry64914CA

General Provider Information

NPI Number : 1669849238
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL LEE DMD
Provider Business Mailing Address
First Line : 9929 LAS TUNAS DR
Second Line :
City : TEMPLE CITY
State : CA
Zip : 91780-2243
Country : US
Telephone Number : 626-283-5504
Fax Number :
Provider Business Practice Location Address
First Line : 9929 LAS TUNAS DR
Second Line :
City : TEMPLE CITY
State : CA
Zip : 91780-2243
Country : US
Telephone Number : 626-283-5504
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2015
Last Update Date : 11/04/2015

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Directions to “ DR. SAMUEL LEE DMD” Practice Location

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