Individual
DR. PETER S CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.M.SC.
Contact information
Practice address
1471 JOHNS LAKE RD STE 1, CLERMONT, FL 34711
(617) 784-1970
Mailing address
1471 JOHNS LAKE RD STE 1, CLERMONT, FL 34711-7005
(617) 784-1970
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
17794
FL
1223E0200X
Endodontics
20256
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942689807
NPI TYPE 2
FL
01
—
X11812
BLUE CROSS & BLUE SHIELD
MA
Enumeration date
12/29/2006
Last updated
06/20/2018
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