Organization
SUSIE T CHAN DDS A PROFESSIONAL DENTAL CORPORTATION
Active
Other names
smile.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSIE T RO DDS (DENTIST)
(714) 421-0430
Entity
Organization
Contact information
Practice address
16918 DOVE CANYON RD, STE 201, SAN DIEGO, CA 92127-3501
(858) 924-1000
Mailing address
16918 DOVE CANYON RD, STE 201, SAN DIEGO, CA 92127-3501
(858) 924-1000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
57743
CA
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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