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General NPI Number Information
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NPI Number | 1376163097
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Entity Type | Individual
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Provider Name | MICHELLE CHEN
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Gender | Female
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 06/13/2020
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Provider Practice Location Address
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Address Line | 149 BRAUER HALL UNC DENTAL SCHOOL
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City | CHAPEL HILL
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State | NC
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Zip | 27599-5819
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Country | US
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Telephone | 919-537-3944
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Fax |
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Provider Business Mailing Address
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Address Line | 32 WINCHESTER ST APT 9
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City | BROOKLINE
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State | MA
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Zip | 02446-2859
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Country | US
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Telephone | 856-316-6615
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11853
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License Number State | NC
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