Provider Demographics
NPI:1124315270
Name:TCHOU, LUISA FERNANDA (DMD)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:FERNANDA
Last Name:TCHOU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22147 SOLIEL CIR W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5348
Mailing Address - Country:US
Mailing Address - Phone:561-414-9709
Mailing Address - Fax:
Practice Address - Street 1:22147 SOLIEL CIR W
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5348
Practice Address - Country:US
Practice Address - Phone:561-414-9709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN194191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice