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General NPI Number Information
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NPI Number | 1902539224
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Entity Type | Individual
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Provider Name | EMILY NICOLE CHAN DMD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 2330 HEMBY LN
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City | GREENVILLE
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State | NC
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Zip | 27834-3775
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Country | US
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Telephone | 252-752-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 221 THUNDER FOREST LN
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City | WENDELL
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State | NC
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Zip | 27591-4425
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Country | US
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Telephone | 617-777-3608
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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 | 12818
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License Number State | NC
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