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General NPI Number Information
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NPI Number | 1710708391
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Entity Type | Organization
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Legal Business Name | IRENE LOUIE DDS PC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 15 TERESITA BLVD APT 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94127-1240
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Country | US
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Telephone | 415-216-7736
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Fax |
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Provider Business Mailing Address
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Address Line | 15 TERESITA BLVD APT 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94127-1240
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRENE LOUIE
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Credential | DDS
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Telephone | 415-216-7736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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