Individual
DR. CLARA TAEYOON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82-68 164TH ST, N BUILDING ROOM 633, QUEENS, NY 11432
(718) 883-3000
Mailing address
4310 CRESCENT ST APT 1810, LONG ISLAND CITY, NY 11101-4260
(347) 921-1098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NA
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
03/26/2019
Last updated
04/30/2024
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