Healthcare Provider Details

I. General information

NPI: 1922519925
Provider Name (Legal Business Name): MICHAEL H. CHOW, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 LAWRENCE ST
METHUEN MA
01844-4446
US

IV. Provider business mailing address

49 LAWRENCE ST
METHUEN MA
01844-4446
US

V. Phone/Fax

Practice location:
  • Phone: 978-689-9777
  • Fax: 978-689-9777
Mailing address:
  • Phone: 978-689-9777
  • Fax: 978-689-9777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14280
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number14280
License Number StateMA

VIII. Authorized Official

Name: DR. MICHAEL H. CHOW
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 978-689-9777