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General NPI Number Information
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NPI Number | 1922925221
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Entity Type | Organization
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Legal Business Name | WATERMAN DENTAL LLC
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 151 WATERMAN ST STE 4
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City | PROVIDENCE
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State | RI
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Zip | 02906-2118
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Country | US
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Telephone | 401-274-2743
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Fax |
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Provider Business Mailing Address
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Address Line | 151 WATERMAN ST STE 4
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City | PROVIDENCE
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State | RI
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Zip | 02906-2118
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Country | US
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Telephone | 401-274-2743
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Fax |
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Authorized Official
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Title or Position | DENTIST/EMPLOYER
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Name | YUJIN LEE
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Credential | DMD
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Telephone | 401-297-5294
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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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