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General NPI Number Information
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NPI Number | 1457730913
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Entity Type | Organization
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Legal Business Name | DR. SOE DENTAL CORPORATION
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 4747 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94112-2729
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Country | US
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Telephone | 415-585-5773
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Fax |
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Provider Business Mailing Address
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Address Line | 4747 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94112-2729
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Country | US
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Telephone | 415-585-5773
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. KYAW SOE
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Credential | DDS
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Telephone | 415-585-5773
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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 | 63892
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License Number State | CA
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