MEDICARE: DR. JANICE C 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
1	1223G0001X	General Practice Dentistry	038439	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740301027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE C LEE DMD

Provider Business Mailing Address
First Line	:	8 BUSINESS PARK CT
Second Line	:
City	:	UTICA
State	:	NY
Zip	:	13502-6308
Country	:	US
Telephone Number	:	315-732-6719
Fax Number	:	315-738-7140

Provider Business Practice Location Address
First Line	:	8 BUSINESS PARK CT
Second Line	:
City	:	UTICA
State	:	NY
Zip	:	13502-6308
Country	:	US
Telephone Number	:	315-732-6719
Fax Number	:	315-738-7140

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/09/2007

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