Individual
ROBERT LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1959 NE PACIFIC STREET HEALTH SCIENCES BUILDING B-241 B, SEATTLE, WA 98195-7573
(206) 543-5860
Mailing address
402 N EUCLID ST, SANTA ANA, CA 92703-2414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DDS110071
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DR61678626
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2022
Last updated
07/01/2025
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