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General NPI Number Information
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NPI Number | 1366815813
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Entity Type | Organization
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Legal Business Name | SOPHYA N MORGHEM DMD, MS CORPORATION
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 919 IRVING ST # 101
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2206
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Country | US
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Telephone | 415-681-7001
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Fax | 415-681-1804
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Provider Business Mailing Address
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Address Line | 919 IRVING STREET, #101
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City | SAN FRANCISCO
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State | CA
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Zip | 94122
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Country | US
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Telephone | 415-681-7001
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Fax | 415-681-1804
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Authorized Official
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Title or Position | OWNER
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Name | DR. SOPHYA MORGHEM
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Credential | DMD, MS
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Telephone | 415-681-7001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 62776
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License Number State | CA
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