Individual
CHANEL RENA TRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1545 ATLANTIC AVE, BROOKLYN, NY 11213-1122
(718) 613-7140
(718) 613-7270
Mailing address
1024 GATES AVE APT 5I, BROOKLYN, NY 11221-6148
(931) 247-8211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13243588
NY
122300000X
Dentist
43783841
NY
122300000X
Dentist
—
NY
Other
Enumeration date
01/16/2019
Last updated
07/21/2022
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