Provider Demographics
NPI:1992893465
Name:LEE, ROBERT CAPERS (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CAPERS
Last Name:LEE
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 1:5635 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-1317
Mailing Address - Country:US
Mailing Address - Phone:803-494-8466
Mailing Address - Fax:803-494-8472
Practice Address - Street 1:5635 BROAD STREET EXT
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154
Practice Address - Country:US
Practice Address - Phone:803-494-8466
Practice Address - Fax:803-494-8472
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice