Organization
LONG SN LEE, D.D.S.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONG SN LEE D.D.S. (PRESIDENT)
(414) 463-0855
Entity
Organization
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
1223G0001X
General Practice Dentistry
Primary
5510
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33777800
—
WI
Enumeration date
05/22/2007
Last updated
08/22/2020
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