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Individual
MIMI JOONYOUNG LEE
Active
Individual
MIMI JOONYOUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
056100-1
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
265566-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
06/26/2008
Last updated
02/25/2016
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