| C. Jack Lee, D.m.d., Inc. | |
|
1321 N Harbor Blvd Suite 200 Fullerton CA 92835-4124 | |
| (714) 871-8343 | |
| (714) 871-2338 |
| Full Name | C. Jack Lee, D.m.d., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1321 N Harbor Blvd, Fullerton, California |
| Authorized Official Name and Position | C. Jack Lee (OWNER) |
| Authorized Official Contact | 7148718343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Jack Lee, D.m.d., Inc. 1321 N Harbor Blvd Suite 200 Fullerton CA 92835-4124 Ph: (714) 871-8343 | C. Jack Lee, D.m.d., Inc. 1321 N Harbor Blvd Suite 200 Fullerton CA 92835-4124 Ph: (714) 871-8343 |
| NPI Number | 1851592950 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 02/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851592950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 45903 (California) | Primary |
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