Provider Demographics
NPI:1588685101
Name:CHAU, VONICA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VONICA
Middle Name:
Last Name:CHAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 MATLOCK RD STE 1004
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2592
Mailing Address - Country:US
Mailing Address - Phone:817-548-8925
Mailing Address - Fax:817-548-0099
Practice Address - Street 1:2621 MATLOCK RD STE 1004
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2592
Practice Address - Country:US
Practice Address - Phone:817-548-8925
Practice Address - Fax:817-548-0099
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX172741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice