Organization
GOTTSCHALK AND LEE DENTAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH KIANFU LEE D.D.S. (OWNER)
(818) 344-4210
Entity
Organization
Contact information
Practice address
5620 WILBUR AVE. SUITE 319, TARZANA, CA 91356-1351
(818) 344-4210
(818) 344-4093
Mailing address
5620 WILBUR AVE. SUITE 319, TARZANA, CA 91356-1351
(818) 344-4210
(818) 344-4093
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
SUR01353F
CA
Other
Enumeration date
06/30/2008
Last updated
06/30/2014
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