Provider Demographics
NPI:1609821123
Name:TOCHAROEN, AUNCHANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AUNCHANA
Middle Name:
Last Name:TOCHAROEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SQUIRES POINTE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334
Mailing Address - Country:US
Mailing Address - Phone:864-433-6888
Mailing Address - Fax:864-433-6889
Practice Address - Street 1:505 SQUIRES POINTE
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334
Practice Address - Country:US
Practice Address - Phone:864-433-6888
Practice Address - Fax:864-433-6889
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX3620Medicaid