Individual
DANIEL DEOKCHUN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1455 BROAD ST STE 105, BLOOMFIELD, NJ 07003-3039
(862) 702-5234
Mailing address
414 HACKENSACK AVE APT 1315, HACKENSACK, NJ 07601-6579
(929) 367-1257
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02852700
NJ
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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