NPI 1336450444

Allen Chan, DMD

Practitioner Dentist Apo, AA

Practice location

Address: 82nd Medical Group (aetc) Pas: Sq0jfb5d Sheppard Afb, Apo, AA 76311
Phone: (210) 565-0645
Mailing address: 674 Hazelton Dr, Madison, MS 39110-7332

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence DS038318 (PA)

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Registry record

NPI: 1336450444
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jun 2010
Record last updated: 24 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.