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NPI 1699773770

IndividualActive

Jay Wylam, DMD

NPI 1699773770 · Periodontics · Salem, OR

Provider details

NPI number: 1699773770
Entity type: Individual
Primary specialty: PeriodonticsDental Providers
Credential: DMD
Sex: Male
License: 6637 (OR)

Specialties & taxonomies

PeriodonticsPrimary1223P0300XLicense 6637 (OR)
Dental Providers

Practice location

2605 12th Pl Se

Salem, OR 97302-2576

Phone: (503) 585-4281

Fax: (503) 585-7427

Approximate (ZIP-level) locationGet directions

More OR providers

Mailing address

2605 12th Pl Se

Salem, OR 97302-2576

Registry dates

Enumerated: 2005-07-12
Last updated: 2007-07-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Jay Wylam, DMD — NPI 1699773770, Salem, OR | NPI Central