Individual
TIM LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9450 FAIRWAY DR, ROSEVILLE, CA 95678-3588
(504) 202-7789
Mailing address
2015 HUTLEY WAY, ROSEVILLE, CA 95746-7161
(504) 202-7789
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DDS63953
CA
Other
Enumeration date
02/19/2010
Last updated
11/22/2021
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