Provider Demographics
NPI:1275643165
Name:TOM D CHO DDS INC
Entity Type:Organization
Organization Name:TOM D CHO DDS INC
Other - Org Name:TOTEM LAKE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-820-1820
Mailing Address - Street 1:12537 116TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:425-820-1820
Mailing Address - Fax:425-820-1829
Practice Address - Street 1:12537 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-820-1820
Practice Address - Fax:425-820-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty