Provider Demographics
NPI:1558823104
Name:JOSHUA J LEE DMD LLC
Entity Type:Organization
Organization Name:JOSHUA J LEE DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:JAE-JOON
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-272-5080
Mailing Address - Street 1:279 CAMBRIDGE ST STE 9
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-2549
Mailing Address - Country:US
Mailing Address - Phone:781-272-5080
Mailing Address - Fax:781-272-5081
Practice Address - Street 1:279 CAMBRIDGE ST STE 9
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-2549
Practice Address - Country:US
Practice Address - Phone:781-272-5080
Practice Address - Fax:781-272-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty