Organization
BADII LEE DENTAL CORPORATION, INC
Active
Other names
Smile Wide
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL H LEE DDS (PRESIDENT)
(909) 798-2755
Entity
Organization
Contact information
Practice address
25733 BARTON RD, LOMA LINDA, CA 92354-3812
(909) 798-2755
(909) 307-2098
Mailing address
25733 BARTON RD, LOMA LINDA, CA 92354-3812
(909) 798-2755
(909) 307-2098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/26/2015
Last updated
11/29/2016
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