Provider Demographics
NPI:1942254396
Name:CHEN, CHUN-KUEI JOHN (DMD)
Entity Type:Individual
Prefix:
First Name:CHUN-KUEI
Middle Name:JOHN
Last Name:CHEN
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 1:1032 TURNPIKE ST
Mailing Address - Street 2:STE 203
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2866
Mailing Address - Country:US
Mailing Address - Phone:781-821-5700
Mailing Address - Fax:781-821-5700
Practice Address - Street 1:191 SOCIAL STREET
Practice Address - Street 2:THUNDERMIST HEALTH CENTER
Practice Address - City:WOONSOCKER
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-767-4161
Practice Address - Fax:401-767-4165
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice