Individual
DR. CHANG JOO LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4 MANCHESTER AVE, DERRY, NH 03038-1931
(603) 434-1586
Mailing address
4 MANCHESTER AVE, DERRY, NH 03038-1931
(603) 434-1586
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1859075
MA
1223G0001X
General Practice Dentistry
34251
TX
1223P0221X
Pediatric Dentistry
Primary
05134
NH
Other
Enumeration date
06/15/2018
Last updated
09/12/2024
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