Provider Demographics
NPI:1568244002
Name:CHAU DENTAL CORPORATION
Entity Type:Organization
Organization Name:CHAU DENTAL CORPORATION
Other - Org Name:CHAU DENTAL CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-673-5810
Mailing Address - Street 1:750 LAS GALLINAS AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3432
Mailing Address - Country:US
Mailing Address - Phone:415-479-4977
Mailing Address - Fax:
Practice Address - Street 1:750 LAS GALLINAS AVE STE 215
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3432
Practice Address - Country:US
Practice Address - Phone:415-479-4977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty