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General NPI Number Information
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NPI Number | 1033648118
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Entity Type | Individual
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Provider Name | JE HONG LEE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 06/12/2017
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Provider Practice Location Address
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Address Line | 68 STAFFORD ST STE 1
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City | WORCESTER
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State | MA
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Zip | 01603-1450
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Country | US
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Telephone | 508-770-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 1227 4TH ST SE APT 205
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-3803
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Country | US
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Telephone | 541-515-9172
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1857614
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License Number State | MA
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