Provider Demographics
NPI:1558566810
Name:ENG, SALLY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:A
Last Name:ENG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:595 MARKET STREET
Mailing Address - Street 2:1130
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105
Mailing Address - Country:US
Mailing Address - Phone:415-243-0356
Mailing Address - Fax:415-243-0758
Practice Address - Street 1:595 MARKET ST
Practice Address - Street 2:1130
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-2802
Practice Address - Country:US
Practice Address - Phone:415-243-0356
Practice Address - Fax:415-243-0758
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist