Provider Demographics
NPI:1174644165
Name:HONICK, PICHADA CHHAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PICHADA
Middle Name:CHHAY
Last Name:HONICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 POSTAL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2601
Mailing Address - Country:US
Mailing Address - Phone:410-643-6608
Mailing Address - Fax:410-643-7345
Practice Address - Street 1:1617 POSTAL RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2601
Practice Address - Country:US
Practice Address - Phone:410-643-6608
Practice Address - Fax:410-643-7345
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice