Organization
GRACE DENTAL UNION CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LEE DDS (OWNER)
(917) 686-5746
Entity
Organization
Contact information
Practice address
3133 CENTRAL AVE STE 204, UNION CITY, NJ 07087-2447
(201) 330-3333
Mailing address
3133 CENTRAL AVE STE 204, UNION CITY, NJ 07087-2447
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
22DI02490600
NJ
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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