Provider Demographics
NPI:1548487515
Name:CHO, WHAN M (DDS)
Entity type:Individual
Prefix:DR
First Name:WHAN
Middle Name:M
Last Name:CHO
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 1:11605 STATE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-8427
Mailing Address - Country:US
Mailing Address - Phone:360-386-9540
Mailing Address - Fax:
Practice Address - Street 1:11605 STATE AVE STE 108
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-6079
Practice Address - Country:US
Practice Address - Phone:206-605-1674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE104681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice