Individual
CARLTON CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15522 HESPERIAN BLVD, SAN LORENZO, CA 94580-1609
(510) 481-1552
Mailing address
15522 HESPERIAN BLVD, SAN LORENZO, CA 94580-1609
(510) 481-1552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
63816
CA
Other
Enumeration date
08/29/2014
Last updated
03/03/2015
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