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General NPI Number Information
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NPI Number | 1447496062
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Entity Type | Organization
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Legal Business Name | CHUN YUK LEE DDS PC
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 01/02/2009
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Provider Practice Location Address
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Address Line | 15 BROAD ST #3108
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City | NEW YORK
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State | NY
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Zip | 10005-1923
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Country | US
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Telephone | 646-483-7603
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Fax |
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Provider Business Mailing Address
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Address Line | 273 GRAND ST 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10002-4417
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Country | US
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Telephone | 212-219-3353
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Fax | 212-219-3354
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHUN Y LEE
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Credential | DDS
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Telephone | 646-483-7603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 050131
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License Number State | NY
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