Provider Demographics
NPI:1942636766
Name:LEE, DANIEL GWONHEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GWONHEE
Last Name:LEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E 23RD ST
Mailing Address - Street 2:5K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4744
Mailing Address - Country:US
Mailing Address - Phone:917-992-5939
Mailing Address - Fax:
Practice Address - Street 1:340 E 23RD ST
Practice Address - Street 2:5K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4744
Practice Address - Country:US
Practice Address - Phone:917-992-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0568041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice