Provider Information for 1669821633
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Dr. PETER B LEE D.D.S., M.S.
Sex: Male
NPI: 1669821633
Last Updated: 2022-03-02
Certification Date: 2022-02-24
Certification Date: 2022-02-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669821633 | ||||||||
| Enumeration Date | 2016-06-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4867 EAGLE ROCK BLVD STE B LOS ANGELES, CA 90041-2649 United States Phone: 323-255-0193 | Fax: | ||||||||
| Primary Practice Address | 4867 EAGLE ROCK BLVD STE B LOS ANGELES, CA 90041-2649 United States Phone: 661-993-1139 | Fax: | ||||||||
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