Individual
JISOO HONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2719 CALUMET AVE, MANITOWOC, WI 54220-5546
(920) 686-2333
Mailing address
2719 CALUMET AVE, MANITOWOC, WI 54220-5546
(920) 686-2333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6000060-15
WI
Other
Enumeration date
03/23/2023
Last updated
09/24/2024
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