Provider Demographics
NPI:1063843910
Name:CHO, BENJAMIN BYOUNGIL (DDS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:BYOUNGIL
Last Name:CHO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 MONUMENT BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3420
Mailing Address - Country:US
Mailing Address - Phone:925-827-3542
Mailing Address - Fax:
Practice Address - Street 1:2256 MONUMENT BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3420
Practice Address - Country:US
Practice Address - Phone:925-827-3542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist