| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SOO JIN LEE | 1518451103 | 2024-11-09 |
Soo Jin Lee is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1518451103. Registration indicates Soo Jin Lee is a provider of services with a specialization in Dentist Orofacial Pain, Dental Providers
| Entity Type | Individual |
| Provider Name | Dr. Soo Jin Lee DMD |
| Practice Office Address | 1318 BEACON ST STE 1 BROOKLINE, MA US |
| Practice Office Telephone | 8578580246 |
| Practice Office Fax | 8578580345 |
| Mailing Address | 1443 BEACON ST APT 706 BROOKLINE, MA 024464712 US |
| Business Telephone | 6786771578 |
| Code | Practice | License No State |
|---|---|---|
| 1223X2210X PRIMARY | Dentist Orofacial Pain Dental Providers | DN10000184
MA |
| 193400000X SING | Group Code |