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General NPI Number Information
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NPI Number | 1962161430
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Entity Type | Organization
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Legal Business Name | YUN YI CHEN DENTAL CORPORATION
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 410 S GLENDORA AVE STE 210
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City | GLENDORA
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State | CA
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Zip | 91741-6207
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Country | US
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Telephone | 626-335-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E BONITA AVE UNIT 3610
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City | SAN DIMAS
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State | CA
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Zip | 91773-6176
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Country | US
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Telephone | 626-622-9802
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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. YUN YI CHEN
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Credential | DDS
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Telephone | 626-622-9802
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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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