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NPI Code Detail

MEDICARE: DR. CYNTHIA JEAN CHOCK DDS

MEDICARE:  DR. CYNTHIA JEAN CHOCK  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry31229CA

General Provider Information

NPI Number : 1376612812
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA JEAN CHOCK DDS
Provider Business Mailing Address
First Line : 2060 E AVENIDA DE LOS ARBOLES
Second Line : SUITE G
City : THOUSAND OAKS
State : CA
Zip : 91362-1361
Country : US
Telephone Number : 805-493-2879
Fax Number : 805-241-1050
Provider Business Practice Location Address
First Line : 2060 E AVENIDA DE LOS ARBOLES
Second Line : SUITE G
City : THOUSAND OAKS
State : CA
Zip : 91362-1361
Country : US
Telephone Number : 805-493-2879
Fax Number : 805-241-1050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CYNTHIA JEAN CHOCK DDS” Practice Location

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