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General NPI Number Information
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NPI Number | 1780272344
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Entity Type | Organization
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Legal Business Name | WILL & CHAN DENTAL CORPORATION
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 473 ENCINITAS BLVD
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City | ENCINITAS
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State | CA
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Zip | 92024-3729
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Country | US
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Telephone | 760-634-2024
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Fax |
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Provider Business Mailing Address
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Address Line | 3124 CHERRYPOINT CT
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City | FALLBROOK
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State | CA
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Zip | 92028-9590
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL CHAN
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Credential | DDS
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Telephone | 951-743-4482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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