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General NPI Number Information
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NPI Number | 1881973774
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Entity Type | Individual
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Provider Name | CHEN CHEN DDS
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Gender | Female
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 5060 AVALA PARK LN
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-2196
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Country | US
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Telephone | 478-227-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 5060 AVALA PARK LN
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-2196
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Country | US
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Telephone | 478-227-2436
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN015273
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 055707
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License Number State | NY
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