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Organization
GOOD NEIGHBOR DENTAL
Active
Organization
GOOD NEIGHBOR DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYU J LEE DMD (DENTIST)
(301) 355-4789
Entity
Organization
Contact information
Practice address
12051 CHESTNUT BRANCH WAY STE C3, CLARKSBURG, MD 20871-5328
(301) 355-4789
Mailing address
12051 CHESTNUT BRANCH WAY STE C3, CLARKSBURG, MD 20871-5328
(301) 355-4789
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15618
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124216593
INDIVIDUAL NPI
—
01
—
1205123346
INDIVIDUAL NPI
—
01
—
1467642181
INDIVIDUAL NPI
—
Enumeration date
10/07/2014
Last updated
10/07/2014
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