Provider Demographics
NPI:1790126746
Name:LEE, SARAH BOHYUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BOHYUN
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 1:121 CHARLES ST S
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5432
Mailing Address - Country:US
Mailing Address - Phone:617-226-2822
Mailing Address - Fax:
Practice Address - Street 1:121 CHARLES ST S
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5432
Practice Address - Country:US
Practice Address - Phone:617-579-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist