MEDICARE: MARGARET SY DMD, A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1588786412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARGARET SY DMD, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	105 E HAVEN AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-2900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	633 N CENTRAL AVE STE 303
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1824
Country	:	US
Telephone Number	:	626-616-0704
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	HEMAN CHUANG
Credential	:
Telephone Number	:	626-616-0704

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/22/2020

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