Provider Demographics
NPI:1346431723
Name:CHAN, GEORGE H C (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:H C
Last Name:CHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 720
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4404
Mailing Address - Country:US
Mailing Address - Phone:808-949-1607
Mailing Address - Fax:808-947-5007
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 720
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4404
Practice Address - Country:US
Practice Address - Phone:808-949-1607
Practice Address - Fax:808-947-5007
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice