Organization
DAVID BLONG S LEE DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BLONG SHONANOU LEE DDS (PRESIDENT)
(920) 459-9010
Entity
Organization
Contact information
Practice address
825 MICHIGAN AVE, SHEBOYGAN, WI 53081
(920) 459-9010
(920) 459-9272
Mailing address
825 MICHIGAN AVE, SEHBOYGAN, WI 53081
(920) 459-9010
(920) 459-9272
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5157
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33757100
—
WI
Enumeration date
05/07/2007
Last updated
08/22/2020
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