Organization
DIVINE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN SEOKKYU LEE D.D.S. (DENTIST/OWNER)
(718) 353-2312
Entity
Organization
Contact information
Practice address
4125 KISSENA BLVD STE 101, FLUSHING, NY 11355-3153
(718) 353-2312
(718) 321-7120
Mailing address
4125 KISSENA BLVD STE 101, FLUSHING, NY 11355-3153
(718) 353-2312
(718) 321-7120
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
052968-1
NY
Other
Enumeration date
04/02/2010
Last updated
04/02/2010
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