Individual
DR. RYAN BUMPER LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
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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