MEDICARE: DR. CHIEN CHUAN CHEN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	38975	CA
2	1223G0001X	General Practice Dentistry	17831	MA

General Provider Information

NPI Number	:	1215931209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHIEN CHUAN CHEN D.M.D.

Provider Business Mailing Address
First Line	:	19155 COLIMA RD
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-3003
Country	:	US
Telephone Number	:	626-854-0091
Fax Number	:	626-854-0991

Provider Business Practice Location Address
First Line	:	19155 COLIMA RD
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-3003
Country	:	US
Telephone Number	:	626-854-0091
Fax Number	:	626-854-0991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/08/2007

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