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General NPI Number Information
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NPI Number | 1073076428
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Entity Type | Organization
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Legal Business Name | CHRIS CHEN DDS INC
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 1014 S GLENDORA AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-4920
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Country | US
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Telephone | 626-858-9858
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Fax |
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Provider Business Mailing Address
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Address Line | 600 GREAT BEND DR
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2033
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Country | US
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Telephone | 626-617-5930
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRIS CHEN
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Credential | DDS
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Telephone | 626-858-9858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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