Individual
DR. RYAN S LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MPH
Contact information
Practice address
335R PRAIRIE AVE, PROVIDENCE, RI 02905-2426
(401) 444-0430
(401) 444-0489
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02464000
NJ
122300000X
Dentist
Primary
DEN03296
RI
1223G0001X
General Practice Dentistry
22DI02464000
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI02464000
NJ
Other
Enumeration date
02/26/2011
Last updated
08/08/2022
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