Individual
MOONHYOUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2630 LIBERTY LN, JANESVILLE, WI 53545-0717
(608) 752-2931
Mailing address
1868 E WASHINGTON AVE, APT 658, MADISON, WI 53704
(813) 767-8389
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
PENDING
WI
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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