Bryan D Lee, DDS, MD is a
Oral & Maxillofacial Surgery based in Rexburg, Idaho. Bryan D Lee is licensed to practice in Idaho (license number M-11482) and his current practice location is
360 E. Main St., Rexburg, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 356-5959.
NPI number for Bryan D Lee is 1790905495 and his current mailing address is 360 E. Main St., Rexburg, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1790905495.
Healthcare Provider's Profile
| Full Name | Bryan D Lee |
|---|
| Gender | Male |
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| Speciality | Oral & Maxillofacial Surgery |
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| Location | 360 E. Main St., Rexburg, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1790905495
- Provider Enumeration Date: 04/26/2007
- Last Update Date: 05/29/2015
Medical Identifiers
Medical identifiers for Bryan D Lee such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790905495 | NPI | - | NPPES |
| 806068200 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | D-3542 (Idaho) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D-3542-OS (Idaho) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | M-11482 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bryan D Lee is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Bryan D Lee, DDS, MD
360 E. Main St.,
Rexburg, ID 83440
Ph: (208) 356-5959 | Bryan D Lee, DDS, MD
360 E. Main St.,
Rexburg, ID 83440
Ph: (208) 356-5959 |
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