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General NPI Number Information
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NPI Number | 1568244002
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Entity Type | Organization
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Legal Business Name | CHAU DENTAL CORPORATION
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 11/11/2023
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Provider Practice Location Address
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Address Line | 750 LAS GALLINAS AVE STE 215
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3432
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Country | US
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Telephone | 415-479-4977
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Fax |
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Provider Business Mailing Address
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Address Line | 750 LAS GALLINAS AVE STE 215
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3432
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Country | US
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Telephone | 415-479-4977
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JUDY CHAU
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Credential | DDS
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Telephone | 510-673-5810
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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 |
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License Number State |
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