Provider Demographics
NPI:1326315920
Name:LEE, CHRISTINA J (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:J
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1420
Mailing Address - Country:US
Mailing Address - Phone:201-786-8199
Mailing Address - Fax:
Practice Address - Street 1:95 SPARTA AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2619
Practice Address - Country:US
Practice Address - Phone:973-940-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ024750001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice