Individual
JAEWOO LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 MAIN ST # 86, TAUNTON, MA 02780-2736
(508) 821-9041
Mailing address
231 HARRISON AVE APT 23, BOSTON, MA 02111-1858
(617) 909-8945
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN10000408
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/09/2023
Last updated
09/11/2024
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