Individual
DR. JACOB K. LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
903 CALLE AMANECER STE 160, SAN CLEMENTE, CA 92673-6272
(949) 361-2838
(949) 361-2838
Mailing address
903 CALLE AMANECER STE 160, SAN CLEMENTE, CA 92673-6272
(949) 361-2838
(949) 361-2838
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
38710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330880247
FEID
CA
Enumeration date
01/22/2007
Last updated
07/08/2007
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