Provider Demographics
NPI:1083792956
Name:CHO, WILLIAM J (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:CHO
Suffix:
Gender:M
Credentials:DDS, MS
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Other - Credentials:
Mailing Address - Street 1:2275 HOSP WAY
Mailing Address - Street 2:APT K
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-6858
Mailing Address - Country:US
Mailing Address - Phone:614-313-4767
Mailing Address - Fax:
Practice Address - Street 1:3144 EL CAMINO REAL STE 104
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:760-720-7372
Practice Address - Fax:760-720-7372
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA510531223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083792956OtherPERIODONTIST