Provider Demographics
NPI:1679583975
Name:GAR N CHAN DDS INC
Entity Type:Organization
Organization Name:GAR N CHAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAR
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-847-1234
Mailing Address - Street 1:7880 WREN AVE
Mailing Address - Street 2:E154
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7802
Mailing Address - Country:US
Mailing Address - Phone:408-847-1234
Mailing Address - Fax:408-842-7494
Practice Address - Street 1:7880 WREN AVE
Practice Address - Street 2:E154
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7802
Practice Address - Country:US
Practice Address - Phone:408-847-1234
Practice Address - Fax:408-842-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29140122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty