Provider Demographics
NPI:1528363975
Name:CHUOP, SERENA B (DMD,CAGS)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:B
Last Name:CHUOP
Suffix:
Gender:F
Credentials:DMD,CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 WARREN ST
Mailing Address - Street 2:SUITE #120
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2647
Mailing Address - Country:US
Mailing Address - Phone:978-455-5044
Mailing Address - Fax:
Practice Address - Street 1:151 WARREN ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2647
Practice Address - Country:US
Practice Address - Phone:978-455-5044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist