Individual
LONG SN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3953 N 76TH ST, MILWAUKEE, WI 53222-3059
(414) 463-0855
(414) 463-0856
Mailing address
3953 N 76TH ST, MILWAUKEE, WI 53222-3059
(414) 463-0855
(414) 463-0856
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5510
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33777800
—
WI
Enumeration date
05/22/2007
Last updated
07/08/2007
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