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General NPI Number Information
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NPI Number | 1336526136
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Entity Type | Organization
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Legal Business Name | SHAOWEI CHEN DDS FAMILY DENTISTRY LLC
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 284 RACEBROOK RD STE 1
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City | ORANGE
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State | CT
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Zip | 06477-3103
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Country | US
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Telephone | 203-795-3868
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Fax |
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Provider Business Mailing Address
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Address Line | 778 MAPLEDALE RD
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City | ORANGE
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State | CT
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Zip | 06477-1704
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Country | US
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Telephone | 561-809-5250
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Fax |
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Authorized Official
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Title or Position | DDS
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Name | SHAOWEI CHEN
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Credential |
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Telephone | 561-809-5250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 011096
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License Number State | CT
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