Provider Demographics
NPI:1356541080
Name:CHO, GRACE H O (DDS)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:H O
Last Name:CHO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 VAN NUYS BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4836
Mailing Address - Country:US
Mailing Address - Phone:818-782-8261
Mailing Address - Fax:818-782-1693
Practice Address - Street 1:8215 VAN NUYS BLVD STE 220
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4836
Practice Address - Country:US
Practice Address - Phone:818-782-8261
Practice Address - Fax:818-782-1693
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35421122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist