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General NPI Number Information
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NPI Number | 1609387356
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Entity Type | Organization
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Legal Business Name | INYOUNG LEE, D.M.D., PLLC
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Dates
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Enumeration Date | 10/21/2017
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Last Update Date | 10/21/2017
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Provider Practice Location Address
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Address Line | 230 E 79TH ST OFC 1
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City | NEW YORK
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State | NY
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Zip | 10075-1256
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Country | US
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Telephone | 845-705-4517
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Fax |
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Provider Business Mailing Address
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Address Line | 230 E 79TH ST OFC 1
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City | NEW YORK
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State | NY
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Zip | 10075-1256
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Country | US
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Telephone | 845-705-4517
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING ASSISTANT
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Name | MARITZA DURAN
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Credential |
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Telephone | 516-229-1441
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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 |
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License Number State | NY
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