Individual
DR. JAY M WYLAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2605 12TH PL SE, SALEM, OR 97302-2576
(503) 585-4281
(503) 585-7427
Mailing address
2605 12TH PL SE, SALEM, OR 97302-2576
(503) 585-4281
(503) 585-7427
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6637
OR
Other
Enumeration date
07/12/2005
Last updated
07/08/2007
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