Individual
JAERIM LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
25 HAZARD AVE, ENFIELD, CT 06082
(845) 372-3603
Mailing address
25 HAZARD AVENUE, ENFIELD, CT 06082
(845) 372-3692
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13890
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2023
Last updated
08/23/2023
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