Provider Demographics
NPI:1568862589
Name:LEE, YUNJI (DMD)
Entity Type:Individual
Prefix:
First Name:YUNJI
Middle Name:
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 1:70 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-2587
Mailing Address - Country:US
Mailing Address - Phone:617-959-4943
Mailing Address - Fax:978-965-4314
Practice Address - Street 1:70 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2587
Practice Address - Country:US
Practice Address - Phone:978-965-4315
Practice Address - Fax:978-965-4314
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18566121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice