Organization
PROCARE DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANG JIN LEE DMD (OWNER)
(508) 743-7888
Entity
Organization
Contact information
Practice address
51 MILL ST, SUITE 4, HANOVER, MA 02339-1641
(508) 743-7888
(888) 594-4595
Mailing address
51 MILL ST, SUITE 4, HANOVER, MA 02339-1641
(508) 743-7888
(888) 594-4555
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
21084
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9762540
—
MA
Enumeration date
09/27/2011
Last updated
10/07/2011
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