Individual
WAI CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6245 N FRESNO ST STE 103, FRESNO, CA 93710
(559) 554-9999
Mailing address
6245 N FRESNO ST STE 103, FRESNO, CA 93710-5270
(559) 554-9999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
056876
NY
1223P0221X
Pediatric Dentistry
Primary
DDS103801
CA
390200000X
Student in an Organized Health Care Education/Training Program
R670
MN
Other
Enumeration date
05/16/2012
Last updated
07/02/2019
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