MEDICARE: DR. DAVID J. 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	14025	FL

General Provider Information

NPI Number	:	1942423397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J. LEE DMD

Provider Business Mailing Address
First Line	:	7002 SHELDON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2305
Country	:	US
Telephone Number	:	813-890-0044
Fax Number	:	813-884-6515

Provider Business Practice Location Address
First Line	:	7002 SHELDON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2305
Country	:	US
Telephone Number	:	813-890-0044
Fax Number	:	813-884-6515

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	08/05/2015

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