Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS027906L | PA |
NPI | 1164566634 |
---|---|
Provider Name | Dr. Phyllis Callahan Lee |
First Address | Pittsburgh, PA 15228-1909 |
Second Address | Pittsburgh, PA 15228-1909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2007 |
Last Update Date | 08/07/2007 |