MEDICARE: DR. DAVID B LEE DDS PA

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	11816	MD

General Provider Information

NPI Number	:	1902824121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID B LEE DDS PA

Provider Business Mailing Address
First Line	:	1111 UNIVERSITY BLVD W
Second Line	:	SUITE G4
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-3351
Country	:	US
Telephone Number	:	301-649-5001
Fax Number	:	301-681-8132

Provider Business Practice Location Address
First Line	:	1111 UNIVERSITY BLVD W
Second Line	:	SUITE G4
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-3351
Country	:	US
Telephone Number	:	301-649-5001
Fax Number	:	301-681-8132

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	08/15/2017

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