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General NPI Number Information
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NPI Number | 1417699364
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Entity Type | Individual
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Provider Name | MARVIN CHEN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 1195 MAGNOLIA AVE
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City | CORONA
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State | CA
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Zip | 92879-3202
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Country | US
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Telephone | 951-339-3005
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Fax |
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Provider Business Mailing Address
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Address Line | 7725 GATEWAY UNIT 3435
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City | IRVINE
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State | CA
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Zip | 92618-5855
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Country | US
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Telephone | 760-808-7598
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 110355
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License Number State | CA
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