Provider Demographics
NPI:1699887471
Name:DREVEN, LEE JAMES (DMD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:JAMES
Last Name:DREVEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4099 WILLIAM PENN HWY STE 907
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2519
Mailing Address - Country:US
Mailing Address - Phone:412-373-1710
Mailing Address - Fax:412-373-1239
Practice Address - Street 1:4099 WILLIAM PENN HWY STE 907
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2519
Practice Address - Country:US
Practice Address - Phone:412-373-1710
Practice Address - Fax:412-373-1239
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020712L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics