Provider Demographics
NPI:1518534353
Name:WOBURN SMILES PC
Entity Type:Organization
Organization Name:WOBURN SMILES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANG
Authorized Official - Middle Name:JIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-726-7788
Mailing Address - Street 1:3112 CRANBERRY HWY UNIT A
Mailing Address - Street 2:
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-4810
Mailing Address - Country:US
Mailing Address - Phone:508-743-7888
Mailing Address - Fax:888-594-4555
Practice Address - Street 1:405 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5466
Practice Address - Country:US
Practice Address - Phone:781-726-7788
Practice Address - Fax:888-594-4555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental