Individual
ISABELLA YIROA CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
428 COLUMBUS AVENUE, DENTAL, NEW HAVEN, CT 06519
(203) 503-3040
(203) 503-3187
Mailing address
400 COLUMBUS AVENUE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3000
(203) 503-6515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12847
CT
390200000X
Student in an Organized Health Care Education/Training Program
12497
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235893
—
CT
Enumeration date
03/27/2019
Last updated
08/10/2020
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