Provider Demographics
NPI:1992017156
Name:CHUONG, CHRISTOPHER ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:CHUONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 HAWBUCK ST
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5360
Mailing Address - Country:US
Mailing Address - Phone:727-478-3210
Mailing Address - Fax:
Practice Address - Street 1:8804 HAWBUCK ST
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5360
Practice Address - Country:US
Practice Address - Phone:727-478-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN189891223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice