Provider Demographics
NPI:1942402730
Name:LEE, KUANGHAN GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KUANGHAN
Middle Name:GEORGE
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:10 DUNWOODIE ST
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5411
Mailing Address - Country:US
Mailing Address - Phone:914-472-9001
Mailing Address - Fax:
Practice Address - Street 1:800 CENTRAL PARK AVE STE 203
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-2589
Practice Address - Country:US
Practice Address - Phone:914-472-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ204261223G0001X
NY48213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice