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NPI Code Detail

MEDICARE: DR. SOE DENTAL CORPORATION

MEDICARE: DR. SOE DENTAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist63892CA

General Provider Information

NPI Number : 1457730913
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. SOE DENTAL CORPORATION
Provider Business Mailing Address
First Line : 4747 MISSION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-2729
Country : US
Telephone Number : 415-585-5773
Fax Number :
Provider Business Practice Location Address
First Line : 4747 MISSION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-2729
Country : US
Telephone Number : 415-585-5773
Fax Number :
Authorized Official
Title or Position : OWNER DENTIST
Name : DR. KYAW SOE
Credential : DDS
Telephone Number : 415-585-5773
Provider Enumeration Date : 05/29/2015
Last Update Date : 05/29/2015

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Directions to “DR. SOE DENTAL CORPORATION ” Practice Location

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