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General NPI Number Information
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NPI Number | 1356761035
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Entity Type | Organization
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Legal Business Name | CHEN-DER, CHIANG DDS A DENTAL CORPORATION
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 2818 E IMPERIAL HWY
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City | BREA
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State | CA
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Zip | 92821-6714
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Country | US
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Telephone | 714-572-2818
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Fax |
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Provider Business Mailing Address
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Address Line | 2818 E IMPERIAL HWY
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City | BREA
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State | CA
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Zip | 92821-6714
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Country | US
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Telephone | 714-572-2818
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHEN DER J CHIANG
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Credential |
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Telephone | 626-369-1177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 38660
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License Number State | CA
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