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Individual

JAE EUN LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1860 VIRGINIA AVE, #8, NORTH BEND, OR 97459-2355
(541) 756-7568
(541) 756-0760
Mailing address
1860 VIRGINIA AVE, #8, NORTH BEND, OR 97459-2355
(541) 756-7568
(541) 756-0760

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
60744
KS
122300000X
Dentist
Primary
D9736
OR

Other

Enumeration date
12/11/2009
Last updated
08/03/2012
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