Provider Demographics
NPI:1750302246
Name:CHOI, DAVID Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Y
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6216 BROCKTON AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2208
Mailing Address - Country:US
Mailing Address - Phone:951-779-8862
Mailing Address - Fax:951-779-0629
Practice Address - Street 1:6216 BROCKTON AVE STE 112
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2208
Practice Address - Country:US
Practice Address - Phone:951-779-8862
Practice Address - Fax:951-779-0629
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA428141223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics