Organization
STEPHANIE CHEN DDS MS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA D EDAHL (OFFICE MANAGER)
(704) 365-0888
Entity
Organization
Contact information
Practice address
2813 COLTSGATE RD, SUITE 100, CHARLOTTE, NC 28211-3798
(704) 365-0888
(704) 365-0889
Mailing address
2813 COLTSGATE RD, SUITE 100, CHARLOTTE, NC 28211-3798
(704) 365-0888
(704) 365-0889
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7991547
—
NC
Enumeration date
05/16/2007
Last updated
09/11/2007
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