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General NPI Number Information
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NPI Number | 1659021665
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Entity Type | Individual
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Provider Name | SHENG HAO LU DDS
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Gender | Male
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 3070 FISH HATCHERY RD
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City | FITCHBURG
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State | WI
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Zip | 53713-3187
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Country | US
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Telephone | 608-274-4701
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Fax |
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Provider Business Mailing Address
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Address Line | 3070 FISH HATCHERY RD
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City | FITCHBURG
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State | WI
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Zip | 53713-3187
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Country | US
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Telephone | 608-274-4701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6001315-15
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License Number State | WI
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