Individual
DR. SEAN T LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(516) 312-1406
Mailing address
1411 E 31ST ST, OAKLAND, CA 94602-1018
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
104390
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104390
CALIFORNIA DENTAL LICENSE
—
Enumeration date
10/04/2019
Last updated
10/04/2019
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