Healthcare Provider Details

I. General information

NPI: 1508252479
Provider Name (Legal Business Name): ORAL APPLIANCE THERAPEUTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43575 MISSION BLVD #515
FREMONT CA
94539-5831
US

IV. Provider business mailing address

43575 MISSION BLVD #515
FREMONT CA
94539-5831
US

V. Phone/Fax

Practice location:
  • Phone: 925-953-2858
  • Fax:
Mailing address:
  • Phone: 925-953-2858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRIS CHUI
Title or Position: MEMBER
Credential:
Phone: 925-953-2858