Individual
IRENE LOUIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
671 ELMIRA RD STE 130, VACAVILLE, CA 95687-4655
(707) 215-5259
Mailing address
15 TERESITA BLVD APT 2, SAN FRANCISCO, CA 94127-1240
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
104714
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91066093E44051
—
CA
Enumeration date
07/02/2018
Last updated
10/17/2024
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