Provider Demographics
NPI:1083054712
Name:LEE, HYUK (DDS)
Entity Type:Individual
Prefix:
First Name:HYUK
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-2141
Mailing Address - Country:US
Mailing Address - Phone:347-501-1110
Mailing Address - Fax:201-377-5300
Practice Address - Street 1:383 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-2141
Practice Address - Country:US
Practice Address - Phone:347-501-1110
Practice Address - Fax:201-377-5300
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist