# LEE R CARRASCO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1013946540
- **Gender:** Man
- **Credential:** MD DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | DS031585L | PA | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | MD418924 | PA | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 04/10/2013