Healthcare Provider Details

I. General information

NPI: 1700089125
Provider Name (Legal Business Name): ALEXANDER E LEE D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SYLVAN AVE
ENGLEWOOD CLIFFS NJ
07632-2413
US

IV. Provider business mailing address

7 SYLVAN AVE
ENGLEWOOD CLIFFS NJ
07632-2413
US

V. Phone/Fax

Practice location:
  • Phone: 201-302-0700
  • Fax: 201-302-9857
Mailing address:
  • Phone: 201-302-0700
  • Fax: 201-302-9857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number18599
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: