Provider Demographics
NPI:1811167919
Name:CHOI, ALFRED W (DDS)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:W
Last Name:CHOI
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 1:1200 COUNTRY CLUB DR APT 4506
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-2181
Mailing Address - Country:US
Mailing Address - Phone:727-432-7231
Mailing Address - Fax:
Practice Address - Street 1:19001 N TAMIAMI TRL STE 4
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7306
Practice Address - Country:US
Practice Address - Phone:239-731-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN11947OtherBOARD OF DENTISTRY FLORIDA