Provider Demographics
NPI:1386776839
Name:LEE, LINDA H (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:H
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 E HILLSDALE BLVD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1281
Mailing Address - Country:US
Mailing Address - Phone:650-525-1033
Mailing Address - Fax:
Practice Address - Street 1:1261 E HILLSDALE BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1281
Practice Address - Country:US
Practice Address - Phone:650-525-1033
Practice Address - Fax:650-525-1833
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOMS821223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery