Chan, Patrick Kiu Tao

Chan, Patrick Kiu Tao is an sole proprietor health care provider with primary practice located at 136 Lincoln St , Boston MA 02111-2506. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Chan, Patrick Kiu Tao can be contacted via phone (617) 451-2111.

Contact Information

Primary practice address
136 Lincoln St Boston MA 02111-2506
Phone: (617) 451-2111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 049683 New York
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 20034 Massachusetts

Profile Details

NPI number 1780722017
LBN Legal business name Chan, Patrick Kiu Tao
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Apr 14th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780722017 NPPES
Missouri MEDICAID 405764200

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