Provider Demographics
NPI:1427296417
Name:LEE, TSUNGLIN JAMES (DMD)
Entity type:Individual
Prefix:
First Name:TSUNGLIN
Middle Name:JAMES
Last Name:LEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:47 E SPRINGFIELD ST
Mailing Address - Street 2:B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3352
Mailing Address - Country:US
Mailing Address - Phone:617-680-5749
Mailing Address - Fax:
Practice Address - Street 1:108 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-5210
Practice Address - Country:US
Practice Address - Phone:978-521-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist