Provider Demographics
NPI:1689889172
Name:AHN, MARJORIE MEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:MEE
Last Name:AHN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 WESTLAKE CTR
Mailing Address - Street 2:#363
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1430
Mailing Address - Country:US
Mailing Address - Phone:415-585-0173
Mailing Address - Fax:
Practice Address - Street 1:235 WESTLAKE CTR
Practice Address - Street 2:#363
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1430
Practice Address - Country:US
Practice Address - Phone:415-585-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist