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General NPI Number Information
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NPI Number | 1427349653
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Entity Type | Organization
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Legal Business Name | SIMON W LIM, DDS INC
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 2320 TARAVAL ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-2252
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Country | US
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Telephone | 415-681-5825
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Fax | 415-681-5617
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Provider Business Mailing Address
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Address Line | 2320 TARAVAL ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-2252
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Country | US
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Telephone | 415-681-5825
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Fax | 415-681-5617
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIMON S LIM
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Credential | DDS
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Telephone | 415-681-5825
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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 | 42254
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License Number State | CA
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