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1841064094
ELLIS CHAN BACK
VALLEJO, CA
NPI
1841064094
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: CA 109664)
Enumeration Date
2023-11-08
Last Update Date
2023-11-08
Business Address
Dr. ELLIS CHAN BACK DDS
3587 SONOMA BLVD
VALLEJO, CA 94590-2945
Phone number: 925-683-4799
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Mailing Address
Dr. ELLIS CHAN BACK DDS
962 EL CAJON DR
DANVILLE, CA 94526-1935
Phone number: 925-683-4799
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