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General NPI Number Information
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NPI Number | 1831893403
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Entity Type | Organization
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Legal Business Name | DANBURYDDS, P.C.
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 72 NEWTOWN RD STE 10
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City | DANBURY
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State | CT
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Zip | 06810-6254
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Country | US
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Telephone | 203-404-5601
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Fax |
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Provider Business Mailing Address
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Address Line | 72 NEWTOWN RD STE 10
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City | DANBURY
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State | CT
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Zip | 06810-6254
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Country | US
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Telephone | 203-404-5601
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. IN KYUNG LEE
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Credential | DDS
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Telephone | 203-404-5601
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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 |
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