| David Blong S Lee Dds Sc | |
|
825 Michigan Ave Sheboygan WI 53081 | |
| (920) 459-9010 | |
| (920) 459-9272 |
| Full Name | David Blong S Lee Dds Sc |
|---|---|
| Speciality | Dentist |
| Location | 825 Michigan Ave, Sheboygan, Wisconsin |
| Authorized Official Name and Position | David Blong Shonanou Lee (PRESIDENT) |
| Authorized Official Contact | 9204599010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Blong S Lee Dds Sc 825 Michigan Ave Sehboygan WI 53081 Ph: (920) 459-9010 | David Blong S Lee Dds Sc 825 Michigan Ave Sheboygan WI 53081 Ph: (920) 459-9010 |
| NPI Number | 1144432469 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144432469 | NPI | - | NPPES |
| 33757100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5157 (Wisconsin) | Primary |
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