Organization
JONATHAN D. LEE, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LEE D.D.S. (PRESIDENT)
(805) 370-0110
Entity
Organization
Contact information
Practice address
555 MARIN ST, SUITE 260, THOUSAND OAKS, CA 91360-4236
(805) 370-0110
(805) 370-3770
Mailing address
555 MARIN ST, SUITE 260, THOUSAND OAKS, CA 91360-4236
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
49924
CA
Other
Enumeration date
04/18/2008
Last updated
09/28/2011
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