Individual
DR. JUSTIN CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8616 WHITNEY AVE, ELMHURST, NY 11373-3865
(718) 651-6581
Mailing address
4026 171ST ST, FLUSHING, NY 11358-2720
(718) 913-0279
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
064107
NY
Other
Enumeration date
04/04/2023
Last updated
08/20/2024
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