Individual
GREGORY CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8211 BRUCEVILLE RD STE 155, SACRAMENTO, CA 95823-2313
(916) 525-7635
Mailing address
19736 AUBURN DR, CUPERTINO, CA 95014-2414
(408) 221-2203
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN1858442
MA
1223P0300X
Periodontics
Primary
DDS107368
CA
1223P0300X
Periodontics
DN1858442
MA
Other
Enumeration date
07/17/2019
Last updated
08/09/2022
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