Provider Demographics
NPI:1891873261
Name:SIU, LILY H (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:H
Last Name:SIU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:380 WEST PORTAL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1428
Mailing Address - Country:US
Mailing Address - Phone:415-566-3833
Mailing Address - Fax:415-566-2909
Practice Address - Street 1:380 WEST PORTAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1428
Practice Address - Country:US
Practice Address - Phone:415-566-3833
Practice Address - Fax:415-566-2909
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335211223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics