Provider Demographics
NPI:1376963397
Name:DR. TIMOTHY P. CHEN D.M.D, PA
Entity Type:Organization
Organization Name:DR. TIMOTHY P. CHEN D.M.D, PA
Other - Org Name:TOOTH TALES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-236-5273
Mailing Address - Street 1:12781 MIRAMAR PKWY
Mailing Address - Street 2:SUITE #306
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2906
Mailing Address - Country:US
Mailing Address - Phone:954-236-5273
Mailing Address - Fax:954-653-2967
Practice Address - Street 1:12781 MIRAMAR PKWY
Practice Address - Street 2:SUITE #306
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2906
Practice Address - Country:US
Practice Address - Phone:954-236-5273
Practice Address - Fax:954-653-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN166821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty