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NPI Code Detail

MEDICARE: ANH SOH LA DDS

MEDICARE:   ANH SOH LA  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019.032367IL

General Provider Information

NPI Number : 1538717327
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANH SOH LA DDS
Provider Business Mailing Address
First Line : 3351 W ADAMS ST
Second Line :
City : CHICAGO
State : IL
Zip : 60624-2904
Country : US
Telephone Number : 415-760-1776
Fax Number :
Provider Business Practice Location Address
First Line : 5635 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-4384
Country : US
Telephone Number : 773-736-1830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2019
Last Update Date : 08/27/2019

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Directions to “ ANH SOH LA DDS” Practice Location

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