Provider Demographics
NPI:1124322722
Name:DORIS LIN-SONG, DDS, INC.
Entity type:Organization
Organization Name:DORIS LIN-SONG, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN-SONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-668-3500
Mailing Address - Street 1:1 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2614
Mailing Address - Country:US
Mailing Address - Phone:415-668-3500
Mailing Address - Fax:415-668-3585
Practice Address - Street 1:1 PARKER AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2614
Practice Address - Country:US
Practice Address - Phone:415-668-3500
Practice Address - Fax:415-668-3585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA464911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty