Healthcare Provider Details

I. General information

NPI: 1790325587
Provider Name (Legal Business Name): MAY CHEN PROFESSIONAL DENTAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 W STATE HIGHWAY 29
GEORGETOWN TX
78628-7022
US

IV. Provider business mailing address

4101 W STATE HIGHWAY 29
GEORGETOWN TX
78628-7022
US

V. Phone/Fax

Practice location:
  • Phone: 512-713-0128
  • Fax: 512-713-0129
Mailing address:
  • Phone: 512-713-0128
  • Fax: 512-713-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MAY CHEN
Title or Position: DDS
Credential:
Phone: 512-713-0128