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Organization
WE SMILE DENTAL TWO PC
Active
Organization
WE SMILE DENTAL TWO PC
Active
Other names
greater dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA MYAE LEE (OWNER)
(646) 314-0196
Entity
Organization
Contact information
Practice address
3213 3RD AVE, BRONX, NY 10451-4265
(646) 314-0196
Mailing address
3213 3RD AVE, BRONX, NY 10451-4265
(646) 314-0196
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
053612
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02902674
—
NY
Enumeration date
04/02/2014
Last updated
04/02/2014
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