Provider Demographics
NPI:1265059828
Name:CHAN, YUEN TING (DMD)
Entity type:Individual
Prefix:
First Name:YUEN TING
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N MURPHY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4336
Mailing Address - Country:US
Mailing Address - Phone:972-836-0108
Mailing Address - Fax:
Practice Address - Street 1:1015 N MURPHY RD STE 100
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4336
Practice Address - Country:US
Practice Address - Phone:972-836-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38237122300000X
IN12013411A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist