Individual
JENNIFER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 HEMION RD, SUFFERN, NY 10901-4919
(845) 202-1367
Mailing address
240 WALKER ST UNIT 3E, CLIFFSIDE PARK, NJ 07010-1184
(845) 270-9199
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062840-01
NY
1223G0001X
General Practice Dentistry
DI2848800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2020
Last updated
11/05/2022
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