Healthcare Provider Details

I. General information

NPI: 1609914753
Provider Name (Legal Business Name): ROBERT ALAN CHOD D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CLEMATIS ST
WEST PALM BEACH FL
33401-5107
US

IV. Provider business mailing address

6526 VIA VICENZA
DELRAY BEACH FL
33446-3740
US

V. Phone/Fax

Practice location:
  • Phone: 561-837-5560
  • Fax:
Mailing address:
  • Phone: 561-310-0497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberHD 1-00470
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDN 16239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: