Provider Demographics
NPI:1235408493
Name:CHO, MARK Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:Y
Last Name:CHO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CANAL ST
Mailing Address - Street 2:SUITE 509
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4155
Mailing Address - Country:US
Mailing Address - Phone:212-285-2828
Mailing Address - Fax:212-285-2829
Practice Address - Street 1:212 CANAL ST
Practice Address - Street 2:SUITE 509
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4155
Practice Address - Country:US
Practice Address - Phone:212-285-2828
Practice Address - Fax:212-285-2829
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice