Individual
DR. KING CHONG CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS, FRCD(C)
Contact information
Practice address
345 E 24TH ST RM 837S, NEW YORK, NY 10010-4020
(212) 992-7081
Mailing address
345 E 24TH ST RM 837S, NEW YORK, NY 10010-4020
(212) 992-7081
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
CHANK2
NY
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
056437-1
NY
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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