Individual
JENNIFER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 BOSTON AVE, BRIDGEPORT, CT 06610-1662
(203) 873-0598
Mailing address
1011 WASHINGTON BLVD UNIT 601, STAMFORD, CT 06901-2224
(512) 554-4102
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14789
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TX
Other
Enumeration date
04/14/2023
Last updated
05/27/2026
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