Provider Demographics
NPI:1538489216
Name:LEE, HWAJOO (DMD)
Entity type:Individual
Prefix:
First Name:HWAJOO
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:H
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:384 LOWELL ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-6323
Mailing Address - Country:US
Mailing Address - Phone:781-245-5788
Mailing Address - Fax:781-587-0476
Practice Address - Street 1:384 LOWELL ST
Practice Address - Street 2:SUITE 106
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-6323
Practice Address - Country:US
Practice Address - Phone:781-245-5788
Practice Address - Fax:781-587-0476
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN203811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice