Provider Demographics
NPI:1003053216
Name:LEE-HIN, GRACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:LEE-HIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PARK AVE
Mailing Address - Street 2:#1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2553
Mailing Address - Country:US
Mailing Address - Phone:212-986-1112
Mailing Address - Fax:212-986-1110
Practice Address - Street 1:80 PARK AVE
Practice Address - Street 2:#1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2553
Practice Address - Country:US
Practice Address - Phone:212-986-1112
Practice Address - Fax:212-986-1110
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0422381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice