Individual
DR. JESSICA MYAE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1959A WESTCHESTER AVE, BRONX, NY 10462-4505
(718) 822-6086
Mailing address
1959A WESTCHESTER AVE, BRONX, NY 10462-4505
(718) 822-6086
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
053612
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02902674
—
NY
Enumeration date
08/14/2007
Last updated
11/30/2023
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