Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN18393 | FL |
NPI | 1043362577 |
---|---|
Provider Name | Chen He |
First Address | West Palm Bch, FL 33409-7464 |
Second Address | Brandon, FL 33511-4704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 16/07/2009 |