Individual
SEONGNOH LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 PROSPECT AVE STE 719, HACKENSACK, NJ 07601-1974
(551) 996-5002
(551) 996-5099
Mailing address
1441 N 12TH ST FL 3, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI03073000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/11/2021
Last updated
03/12/2026
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