Individual
DR. PATRICK KIU TAO CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
136 LINCOLN ST, BOSTON, MA 02111-2506
(617) 451-2111
Mailing address
136 LINCOLN ST, BOSTON, MA 02111-2506
(617) 451-2111
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
049683
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20034
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405764200
—
MO
Enumeration date
02/01/2007
Last updated
04/14/2018
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