Individual
MIANA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
7312 W APPLETON AVE, MILWAUKEE, WI 53216-1914
(414) 477-4079
Mailing address
7312 W APPLETON AVE, MILWAUKEE, WI 53216-1914
(414) 477-4079
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001126
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2015
Last updated
06/23/2015
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