Provider Demographics
NPI:1083753750
Name:CHO, KWANG JE (DDS)
Entity Type:Individual
Prefix:MR
First Name:KWANG
Middle Name:JE
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 1:8330 PAINTER AVE
Mailing Address - Street 2:#B
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602
Mailing Address - Country:US
Mailing Address - Phone:562-696-3334
Mailing Address - Fax:562-698-3964
Practice Address - Street 1:8330 PAINTER AVE
Practice Address - Street 2:#B
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602
Practice Address - Country:US
Practice Address - Phone:562-696-3334
Practice Address - Fax:562-698-3964
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice