Individual
DR. RYAN BUMPER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5345 SPRING ST, DAVENPORT, IA 52807-2764
(563) 359-1601
Mailing address
5345 SPRING ST, DAVENPORT, IA 52807-2764
(563) 359-1601
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
08664
IA
390200000X
Student in an Organized Health Care Education/Training Program
08664
IA
Other
Enumeration date
06/12/2009
Last updated
01/10/2020
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