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General NPI Number Information
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NPI Number | 1417818840
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Entity Type | Organization
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Legal Business Name | NEW JERSEY TONGUE-TIE CENTER LLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 727 ADAMS ST UNIT 2
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City | HOBOKEN
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State | NJ
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Zip | 07030-3391
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Country | US
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Telephone | 201-515-5534
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Fax |
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Provider Business Mailing Address
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Address Line | 727 ADAMS ST UNIT 2
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City | HOBOKEN
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State | NJ
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Zip | 07030-3391
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Country | US
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Telephone | 201-515-5534
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHUL WON LEE
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Credential | D.M.D.
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Telephone | 917-755-1927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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