Individual
BRIAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
430 N EL CAMINO REAL, SAN MATEO, CA 94401-3710
(650) 727-3480
Mailing address
931 SAN BRUNO AVE W RM 5, SAN BRUNO, CA 94066-3435
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
106990
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/29/2020
Last updated
09/22/2021
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