Organization
CHENG DDS MD INC AND WEN S FAN DMD MD INC A PARTNERSHIP
Active
Other names
Maxillofacial Surgery Center of San Jose
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIEN YVAN CHENG DDS, MD (OWNER/PARTNER)
(408) 298-7775
Entity
Organization
Contact information
Practice address
2039 FOREST AVENUE, SUITE #306, SAN JOSE, CA 95128
(408) 298-7775
(408) 298-0936
Mailing address
2039 FOREST AVENUE, SUITE #306, SAN JOSE, CA 95128
(408) 298-7775
(408) 298-0936
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
FNP2936
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
23580
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
45438
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
52603
CA
Other
Enumeration date
08/02/2006
Last updated
04/04/2011
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