Provider Demographics
NPI:1982636171
Name:CHOU, MICHAEL CC (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CC
Last Name:CHOU
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 1:1417 YANCEYVILLE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6931
Mailing Address - Country:US
Mailing Address - Phone:336-273-9759
Mailing Address - Fax:336-574-2722
Practice Address - Street 1:1417 YANCEYVILLE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6931
Practice Address - Country:US
Practice Address - Phone:336-273-9759
Practice Address - Fax:336-574-2722
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice