Provider Demographics
NPI:1578324075
Name:CHUL WON LEE DMD PC
Entity Type:Organization
Organization Name:CHUL WON LEE DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUL WON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:917-755-1927
Mailing Address - Street 1:727 ADAMS STREET
Mailing Address - Street 2:COMMERCIAL #1
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030
Mailing Address - Country:US
Mailing Address - Phone:201-479-2752
Mailing Address - Fax:
Practice Address - Street 1:727 ADAMS STREET
Practice Address - Street 2:COMMERCIAL #1
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030
Practice Address - Country:US
Practice Address - Phone:201-479-2752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty