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General NPI Number Information
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NPI Number | 1336413574
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Entity Type | Organization
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Legal Business Name | ESTATE OF CHUNG-YI CHEN, D.D.S.
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4343 KISSENA BLVD SUITE #116
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City | FLUSHING
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State | NY
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Zip | 11355-2950
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Country | US
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Telephone | 718-445-4770
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Fax |
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Provider Business Mailing Address
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Address Line | 4343 KISSENA BLVD SUITE #116
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City | FLUSHING
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State | NY
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Zip | 11355-2950
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Country | US
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Telephone | 718-445-4770
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AI-MEI CHEN
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Credential |
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Telephone | 646-996-8624
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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 | NY
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