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TYRONE CHAN D.D.S.

Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental Providers

Registrant NPI Number: 1720024987

Individual Registrant:
 TYRONE  CHAN D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
2645 OCEAN AVENUE SUITE 302 SAN FRANSISCO, CA 94132 US
Tel: 415-333-8819  Fax: 510-451-3968

Contact information for business:
2645 OCEAN AVENUE SUITE 302 SAN FRANSISCO, CA 94132 US
Tel: 415-333-8819  Fax: 209-478-6890

Registration Information:
NPI: 1720024987
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N1223X0400XDental Providers
Dentist
Orthodontics and Dentofacial Orthopedics
CA40343
Y122300000XDental Providers
Dentist
CA40343

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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