Provider Demographics
NPI:1083822555
Name:DAVID CHODES, D.D.S., P.C.
Entity Type:Organization
Organization Name:DAVID CHODES, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHODES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-431-4444
Mailing Address - Street 1:501 STILLWELLS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2965
Mailing Address - Country:US
Mailing Address - Phone:732-431-4444
Mailing Address - Fax:732-431-4446
Practice Address - Street 1:501 STILLWELLS CORNER RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2965
Practice Address - Country:US
Practice Address - Phone:732-431-4444
Practice Address - Fax:732-431-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01733600261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental