Provider Demographics
NPI:1861538761
Name:LEE, PATRICK C (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:C
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 1:1801 W ROMNEYA DR
Mailing Address - Street 2:SUITE 509
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1830
Mailing Address - Country:US
Mailing Address - Phone:714-778-9288
Mailing Address - Fax:714-778-6989
Practice Address - Street 1:1801 W ROMNEYA DR
Practice Address - Street 2:SUITE 509
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1830
Practice Address - Country:US
Practice Address - Phone:714-778-9288
Practice Address - Fax:714-778-6989
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43543OtherDENTAL LICENSE NUMBER