Provider Demographics
NPI:1366420671
Name:LEE, ALBERT S (DDS)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:S
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 FLORIN RD STE 15
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-4200
Mailing Address - Country:US
Mailing Address - Phone:916-393-9968
Mailing Address - Fax:916-393-9638
Practice Address - Street 1:1355 FLORIN RD STE 15
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822
Practice Address - Country:US
Practice Address - Phone:916-393-9968
Practice Address - Fax:916-393-9638
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice