Provider Demographics
NPI:1669729299
Name:CHOU, MICHELLE YUCHING (DDS, MPH, DMSC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:YUCHING
Last Name:CHOU
Suffix:
Gender:F
Credentials:DDS, MPH, DMSC
Other - Prefix:DR
Other - First Name:YUCHING
Other - Middle Name:
Other - Last Name:CHOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MPH
Mailing Address - Street 1:290 BAKER AVE
Mailing Address - Street 2:SUITE S-200
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742
Mailing Address - Country:US
Mailing Address - Phone:978-369-6248
Mailing Address - Fax:
Practice Address - Street 1:290 BAKER AVE
Practice Address - Street 2:SUITE S-200
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742
Practice Address - Country:US
Practice Address - Phone:978-369-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18566711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics