MEDICARE: DR. CHRISTOPHER NOEL 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	109356	CA

General Provider Information

NPI Number	:	1689443764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER NOEL LEE DDS

Provider Business Mailing Address
First Line	:	1025 LAKERIDGE PL
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94582-4818
Country	:	US
Telephone Number	:	925-399-8972
Fax Number	:

Provider Business Practice Location Address
First Line	:	1283 22ND AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-1601
Country	:	US
Telephone Number	:	415-753-9888
Fax Number	:

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

Provider Enumeration Date	:	12/29/2023
Last Update Date	:	12/29/2023

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