Provider Demographics
NPI:1922540475
Name:SALLY A. ENG, DDS , INC
Entity Type:Organization
Organization Name:SALLY A. ENG, DDS , INC
Other - Org Name:SALLY A. ENG, DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-601-8627
Mailing Address - Street 1:291 GEARY ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1806
Mailing Address - Country:US
Mailing Address - Phone:415-395-9855
Mailing Address - Fax:415-395-9858
Practice Address - Street 1:291 GEARY ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1806
Practice Address - Country:US
Practice Address - Phone:415-395-9855
Practice Address - Fax:415-395-9858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty