Individual
BENNET S LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
2050 N ACACIA AVE, FULLERTON, CA 92831-1259
(714) 871-5691
(714) 871-5691
Mailing address
2050 N ACACIA AVE, FULLERTON, CA 92831-1259
(714) 871-5691
(714) 871-5691
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
21324
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
59926
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205109
—
MA
Enumeration date
01/08/2007
Last updated
12/13/2010
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