Provider Demographics
NPI:1902193659
Name:LEE, CELINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CELINE
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 1:40 RT 94
Mailing Address - Street 2:VERNON COLONIAL PLAZA
Mailing Address - City:MCAFEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07428
Mailing Address - Country:US
Mailing Address - Phone:973-209-4944
Mailing Address - Fax:
Practice Address - Street 1:40 RT 94
Practice Address - Street 2:VERNON COLONIAL PLAZA
Practice Address - City:MCAFEE
Practice Address - State:NJ
Practice Address - Zip Code:07428
Practice Address - Country:US
Practice Address - Phone:973-209-4944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02447101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice