Individual
JAMES CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4701 W INDIAN SCHOOL RD, PHOENIX, AZ 85031-2719
(623) 245-8461
Mailing address
4701 W INDIAN SCHOOL RD, PHOENIX, AZ 85031-2719
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5729
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
796279
AHCCCS ID#
AZ
Enumeration date
12/27/2006
Last updated
07/08/2007
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