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Organization
JASON S LEE DDS INC
Active
Organization
JASON S LEE DDS INC
Active
Other names
Signature Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON S LEE DDS (CEO)
(909) 910-8282
Entity
Organization
Contact information
Practice address
1183 E FOOTHILL BLVD, UNIT 240, UPLAND, CA 91786-4049
(909) 981-6882
(909) 981-0276
Mailing address
1183 E FOOTHILL BLVD, UNIT 240, UPLAND, CA 91786-4049
(909) 981-6882
(909) 981-0276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01604010
UNITED CONCORDIA NUMBER
CA
01
—
247386
DELTA DENTAL # FOR UPLAND
CA
05
—
G93055-01
—
CA
01
—
G98378-01
DELTA HEALTHY FAMILY
CA
Enumeration date
01/23/2007
Last updated
12/28/2008
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