Individual
JI WOO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 WINDING DR STE 105, PHILADELPHIA, PA 19131-2993
(215) 883-0611
Mailing address
1 WINDING DR STE 105, PHILADELPHIA, PA 19131-2993
(215) 883-0611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041310
PA
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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