Individual
JENNA YEONKYUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
11 KIEL AVE, KINNELON, NJ 07405-2549
(973) 838-7888
Mailing address
11 KIEL AVE, KINNELON, NJ 07405-2549
(973) 838-7888
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02964700
NJ
1223P0221X
Pediatric Dentistry
DN1859409
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2020
Last updated
07/14/2023
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