MEDICARE: YANG CHEN DMD

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	DS036849	PA

General Provider Information

NPI Number	:	1811043821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANG CHEN DMD

Provider Business Mailing Address
First Line	:	1058 RYANS RUN
Second Line	:
City	:	BOOTHWYN
State	:	PA
Zip	:	19061-4411
Country	:	US
Telephone Number	:	610-643-4308
Fax Number	:

Provider Business Practice Location Address
First Line	:	6780 MARKET ST
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2431
Country	:	US
Telephone Number	:	610-352-7600
Fax Number	:	610-352-1364

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/08/2007

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