Individual
BRIAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1100 PARK PL STE 30, SAN MATEO, CA 94403-7106
(650) 627-8191
Mailing address
1100 PARK PL STE 30, SAN MATEO, CA 94403-7106
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
CA103105
CA
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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