Provider Demographics
NPI:1225872112
Name:MICHELLE CHEN CORPORATION
Entity type:Organization
Organization Name:MICHELLE CHEN CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-233-3100
Mailing Address - Street 1:12732 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1303
Mailing Address - Country:US
Mailing Address - Phone:510-233-3100
Mailing Address - Fax:510-233-3434
Practice Address - Street 1:12732 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-1303
Practice Address - Country:US
Practice Address - Phone:510-233-3100
Practice Address - Fax:510-233-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental