Provider Demographics
NPI:1760730964
Name:HO, CHI M (DDS)
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:M
Last Name:HO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1175 ARNOLD DR
Mailing Address - Street 2:SUITE #C
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4152
Mailing Address - Country:US
Mailing Address - Phone:925-229-3232
Mailing Address - Fax:925-228-1420
Practice Address - Street 1:1175 ARNOLD DR
Practice Address - Street 2:SUITE #C
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4152
Practice Address - Country:US
Practice Address - Phone:925-229-3232
Practice Address - Fax:925-228-1420
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA616981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice