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General NPI Number Information
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NPI Number | 1417000712
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Entity Type | Individual
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Provider Name | CHIHWEN ALEC YEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 9131 PISCATAWAY RD SUITE 720
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City | CLINTON
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State | MD
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Zip | 20735-2508
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Country | US
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Telephone | 301-868-7716
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Fax |
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Provider Business Mailing Address
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Address Line | 7903 ORION CIR UNIT 106
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City | LAUREL
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State | MD
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Zip | 20724-3101
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Country | US
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Telephone | 617-416-1536
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 12725
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License Number State | MD
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