Individual
JAY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2080 CENTURY PARK E STE 610, LOS ANGELES, CA 90067-2009
(310) 842-4811
Mailing address
2080 CENTURY PARK EAST SUITE 610, LOS ANGELES, CA 90035
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
101264
CA
208600000X
Surgery Physician
149022
CA
Other
Enumeration date
03/28/2011
Last updated
07/12/2017
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