Provider Demographics
NPI:1740785476
Name:JOHN H CHO DDS LLC
Entity Type:Organization
Organization Name:JOHN H CHO DDS LLC
Other - Org Name:CHEHALIS FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-740-9999
Mailing Address - Street 1:1299 BISHOP RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-8758
Mailing Address - Country:US
Mailing Address - Phone:360-740-9999
Mailing Address - Fax:360-740-9998
Practice Address - Street 1:1299 BISHOP RD STE B
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-8758
Practice Address - Country:US
Practice Address - Phone:360-740-9999
Practice Address - Fax:360-740-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60453236261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental