Provider Demographics
NPI:1447317292
Name:LEE, CLARENCE E (DDS)
Entity type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:E
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 1:85-876 FARRINGTON HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-2498
Mailing Address - Country:US
Mailing Address - Phone:808-696-4049
Mailing Address - Fax:808-696-4188
Practice Address - Street 1:85-876 FARRINGTON HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-2498
Practice Address - Country:US
Practice Address - Phone:808-696-4049
Practice Address - Fax:808-696-4188
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-17621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice