Individual
LEE MIYAUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
654 W 4TH ST # A, SAN BERNARDINO, CA 92410-3216
(909) 693-4103
Mailing address
7051 ANGORA ST, CHINO, CA 91710-8332
(323) 631-7797
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
105219
CA
Other
Enumeration date
04/30/2021
Last updated
07/06/2022
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