Provider Demographics
NPI:1336276500
Name:CHO, HYUNG CHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HYUNG CHAN
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:75 SAINT ALPHONSUS ST
Mailing Address - Street 2:#207
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-1676
Mailing Address - Country:US
Mailing Address - Phone:917-881-6492
Mailing Address - Fax:978-686-1592
Practice Address - Street 1:100 AMESBURY ST
Practice Address - Street 2:203
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1321
Practice Address - Country:US
Practice Address - Phone:978-686-8500
Practice Address - Fax:978-686-1592
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA216961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice