Provider Demographics
NPI:1124353628
Name:QUON, SUE JANE (DDS)
Entity type:Individual
Prefix:DR
First Name:SUE
Middle Name:JANE
Last Name:QUON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:4150 CLEMENT STREET
Mailing Address - Street 2:DENTAL SERVICE, #160
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-0001
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-750-6603
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:DENTAL SERVICE, #160
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6603
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2017-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA0331551223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics