Provider Demographics
NPI:1730203977
Name:LEE, ALISON H (DMD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:H
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 1:209 MAIN ST
Mailing Address - Street 2:2ND FL.
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1620
Mailing Address - Country:US
Mailing Address - Phone:201-440-3733
Mailing Address - Fax:201-440-1967
Practice Address - Street 1:209 MAIN ST
Practice Address - Street 2:2ND FL.
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1620
Practice Address - Country:US
Practice Address - Phone:201-440-3733
Practice Address - Fax:201-440-1967
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021558001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice