Provider Demographics
NPI:1396854188
Name:SON, CHLOE M (DMD)
Entity type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:M
Last Name:SON
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 1:200 N CASS ST
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1161
Mailing Address - Country:US
Mailing Address - Phone:269-471-7970
Mailing Address - Fax:269-471-9508
Practice Address - Street 1:200 N CASS ST
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1161
Practice Address - Country:US
Practice Address - Phone:269-471-7970
Practice Address - Fax:269-471-9508
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010-185171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice