Provider Demographics
NPI:1245326644
Name:CHIN, ANNA M (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:M
Last Name:CHIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ROSELAND AVE.
Mailing Address - Street 2:STE. 6
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5937
Mailing Address - Country:US
Mailing Address - Phone:973-403-3455
Mailing Address - Fax:973-403-7804
Practice Address - Street 1:155 ROSELAND AVE.
Practice Address - Street 2:STE. 6
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5937
Practice Address - Country:US
Practice Address - Phone:973-403-3455
Practice Address - Fax:973-403-7804
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1021651001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice