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General NPI Number Information
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NPI Number | 1578600276
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Entity Type | Organization
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Legal Business Name | SONNY LIM D.M.D. INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 1837 E GIBSON RD SUITE D
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City | WOODLAND
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State | CA
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Zip | 95776-5163
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Country | US
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Telephone | 530-406-1730
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Fax | 530-406-0108
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Provider Business Mailing Address
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Address Line | 1837 E GIBSON RD SUITE D
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City | WOODLAND
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State | CA
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Zip | 95776-5163
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Country | US
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Telephone | 530-406-1730
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Fax | 530-406-0108
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SONNY SY LIM
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Credential | DMD
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Telephone | 15304061730
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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 | 43363
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License Number State | CA
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