Provider Demographics
NPI:1639598980
Name:EDWARD M. CHO D.D.S. LTD.
Entity Type:Organization
Organization Name:EDWARD M. CHO D.D.S. LTD.
Other - Org Name:LAKEVIEW DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:MING
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-271-9816
Mailing Address - Street 1:32 N CASS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1602
Mailing Address - Country:US
Mailing Address - Phone:630-271-9816
Mailing Address - Fax:630-271-9814
Practice Address - Street 1:32 N CASS AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1602
Practice Address - Country:US
Practice Address - Phone:630-271-9816
Practice Address - Fax:630-271-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-020092122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty