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General NPI Number Information
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NPI Number | 1689744088
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Entity Type | Individual
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Provider Name | JAMES CHU-WEN FANG D.D.S
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 290 MADISON AVE STE 1A
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7401
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Country | US
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Telephone | 973-538-5338
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Fax | 973-538-5343
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Provider Business Mailing Address
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Address Line | 2299 STOCKER LN
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City | SCOTCH PLAINS
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State | NJ
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Zip | 07076-2119
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Country | US
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Telephone | 908-889-4363
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 050556
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI02454800
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License Number State | NJ
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