Individual
DR. MAYLENE CHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21506
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4041
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4041
—
SC
Enumeration date
05/19/2006
Last updated
11/06/2014
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