Individual
JI YOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
960 MORRIS PARK AVE, BRONX, NY 10462-3715
(718) 377-6453
Mailing address
2100 EASTCHESTER RD APT 5H, BRONX, NY 10461-2238
(617) 610-9928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061342-01
NY
Other
Enumeration date
07/08/2019
Last updated
12/07/2021
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