Provider Demographics
NPI:1700080348
Name:CHOW, SAMUEL KAR-YEUNG (DDS)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:KAR-YEUNG
Last Name:CHOW
Suffix:
Gender:M
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:PO BOX 1137
Mailing Address - Street 2:1202 GARRISON ROAD SUITE 3
Mailing Address - City:FORT ERIE
Mailing Address - State:ONTATIO
Mailing Address - Zip Code:L2A5M9
Mailing Address - Country:CA
Mailing Address - Phone:905-871-7888
Mailing Address - Fax:
Practice Address - Street 1:1202 GARRISON ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:FORT ERIE
Practice Address - State:ONTATIO
Practice Address - Zip Code:L2A5M9
Practice Address - Country:CA
Practice Address - Phone:905-871-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06111881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice