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General NPI Number Information
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NPI Number | 1972711455
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Entity Type | Individual
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Provider Name | HAEJIN LEE D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 23 S SPRINGFIELD AVE
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-2301
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Country | US
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Telephone | 973-379-0055
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Fax |
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Provider Business Mailing Address
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Address Line | 318 GREENFIELD RD
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-3715
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Country | US
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Telephone | 908-595-0425
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DI02137900
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License Number State | NJ
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