Individual
ANGELINE Y CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S, CAGS
Contact information
Practice address
618 CHURCH ST, SUITE 520, NASHVILLE, TN 37219-2428
(615) 750-0323
Mailing address
18 DAY ST, APT 312, SOMERVILLE, MA 02144-2806
(920) 217-1751
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6039
WI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21406
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33801500
—
WI
Enumeration date
09/12/2006
Last updated
04/05/2011
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