Provider Demographics
NPI:1235346727
Name:HO, GORDON FOOK CHUEN (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:FOOK CHUEN
Last Name:HO
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 CALLE LA MONTANA
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1609
Mailing Address - Country:US
Mailing Address - Phone:925-283-8225
Mailing Address - Fax:
Practice Address - Street 1:2600 SPRINGS RD
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-5713
Practice Address - Country:US
Practice Address - Phone:707-642-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA446951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice