Individual
DR. ILKYU JASON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 363-3311
(503) 364-4950
Mailing address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 363-3311
(503) 364-4950
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6545
OK
122300000X
Dentist
Primary
D10102
OR
Other
Enumeration date
08/26/2013
Last updated
10/23/2014
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