BRYAN D LEE

REXBURG, ID
NPI1790905495
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
(Licence: ID  M-11482)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: ID  D-3542)
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: ID  D-3542-OS)
Enumeration Date2007-04-26
Last Update Date2015-05-29
Business Address
-- BRYAN D LEE DDS, MD
360 E. MAIN ST.
REXBURG, ID 83440
Phone number: 208-356-5959
Mailing Address
-- BRYAN D LEE DDS, MD
360 E. MAIN ST.
REXBURG, ID 83440
Phone number: 208-356-5959