Individual
DR. JASON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4257 POINT LA VISTA RD W, JACKSONVILLE, FL 32207-6247
(904) 703-2236
Mailing address
4257 POINT LA VISTA RD W, JACKSONVILLE, FL 32207-6247
(904) 703-2236
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D7521
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN18554
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DTP477
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0767638-00
—
FL
05
—
461503733A
—
GA
Enumeration date
12/08/2006
Last updated
01/07/2025
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