Provider Demographics
NPI:1366683591
Name:LORA L CHOW DMD PC
Entity Type:Organization
Organization Name:LORA L CHOW DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-970-9442
Mailing Address - Street 1:400 E RANDOLPH ST
Mailing Address - Street 2:#3202
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7329
Mailing Address - Country:US
Mailing Address - Phone:617-970-9442
Mailing Address - Fax:
Practice Address - Street 1:400 E RANDOLPH ST
Practice Address - Street 2:#3202
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7329
Practice Address - Country:US
Practice Address - Phone:617-970-9442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0022941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty