Provider Demographics
NPI:1588643498
Name:DOKKO, CHUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHUL
Middle Name:
Last Name:DOKKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:C
Other - Last Name:DOKKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1950 MARKET ST
Mailing Address - Street 2:BLD #D
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2686
Mailing Address - Country:US
Mailing Address - Phone:925-356-2828
Mailing Address - Fax:
Practice Address - Street 1:1950 MARKET ST
Practice Address - Street 2:BLD #D
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2686
Practice Address - Country:US
Practice Address - Phone:925-356-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87831223G0001X
CA557921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice