Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401415422 | VA |
NPI | 1003367244 |
---|---|
Provider Name | Dr. Tsu Yin Chen |
First Address | Jacksonville, FL 32212 |
Second Address | Jacksonville, FL 32212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 24/10/2016 |